Bermuda has one main Accident
and Emergency (A&E) hospital - King Edward VII Memorial Hospital (KEMH)
- located at Point Finger
Road, Paget Parish DV 04,
Bermuda. Postal address P.
O. Box HM 444, Hamilton HM BX.
Phone (441) 236-2345. Fax (441) 236-2213. KEMH is Bermuda Government owned and operated.
When first established and purpose-built in 1920 by the Bermuda Government it
replaced the old Cottage Hospital (once visited by Mark Twain) in Happy Valley
Road, Devonshire Parish. It was so-named to honour Queen Victoria's eldest son
Albert (nick-named Bertie), who married Princess Alexandra of Denmark in 1863
and took the name of King Edward VII when he finally ascended the British Throne
in 1901 at the age of 60. He reigned for only nine years, dying in 1910. Since
first constructed as a single unit it has gobbled up once-nearby buildings in
constant expansions and renovations along both Point Finger and Berry Hill Road.
One such then-prominent residence was Abbotsford, once owned by prominent
physician, amateur architect and botanist Dr. Henry Hinson. In the 1940s, during World War 2, the British (not Bermuda) Government made some
war-time improvements.

KEMH is today operated by the Bermuda
Ministry of Health and Family Services, via the Bermuda
Government-appointed Bermuda Hospitals Board
(BHB), a publicly-funded quango (quasi autonomous non-governmental organization) established under the Bermuda
Hospitals Board Act, 1970. The BHB is not a private business. It is a quango,
owned by the Government on behalf of the people of Bermuda and administered by a
board appointed by the Government on behalf of the people of Bermuda. It also
has wholly-owned subsidiaries, Healthcare Partners Ltd (HPL) and Ultimate
Imaging Limited. BHB
is
funded entirely by the people of Bermuda by way of direct payments, insurance,
donations and Government subsidies. Its employees are paid by the people of
Bermuda. However, salaries and bonuses of senior managers of the hospital are
not made known to taxpayers. It has a Bermuda Government-approved Board and a
Chief Executive Officer, responsible for King Edward VII Memorial Hospital and
Mid-Atlantic Wellness Institute. At the heart of both organizations is high
quality care to all patients. With approximately 1,800 employees, the Bermuda
Government-owned Bermuda
Hospitals Board is Bermuda’s second largest employer, after the Bermuda
Government itself (about 5,900 employees of all ranks). There is also Paget
Health Services, a
combined public/private sector entity that has built the new (2014) Acute Care
wing at Bermuda's King Edward VII Memorial Hospital.

King Edward VII Memorial
Hospital and the Mid-Atlantic Wellness Institute - Bermuda's second hospital,not an A&E unit but a psychiatric one, not for visitors but residents
only - are the only healthcare
organizations in Bermuda accredited by Accreditation Canada, an independent
organization whose role is to help hospitals examine and improve the quality of
care and service they provide to their clients. In addition to providing an
extensive list of services for the community, the Bermuda Hospitals Board is
part of a referral network that includes some of the world’s leading
specialist hospitals. For more information, please log on to www.bermudahospitals.com

Newcomers, including those from
the United Kingdom, should note there is no equivalent in Bermuda to a
treasured national UK institution, the National Health Service (NHS) - see http://en.wikipedia.org/wiki/National_Health_Service
- that started in 1948. There, State-funded NHS provides free hospitals and
health treatment to all Britons including free prescriptions and free dentistry
and eyesight matters for low-paid Britons, and is embraced by all political
parties. While grumbling about its perceived slow service is widespread - and
planned government reforms are controversial - its egalitarian ethos is a matter
of national pride.

Bermuda's two hospitals above
are not in any way part of the UK's NHS
and its hospitals system. Bermuda
is the only country in the world where the residents and visitors pay not once
but three times for hospital and medical services. In the USA, where hospitals
are privately financed built and operated, patients pay for all services they
use. In Canada, Australia, New Zealand, the UK, Europe, etc. the great majority
of hospitals are financed by taxpayers with hospital and medical services
included in the taxes paid. But in Bermuda, taxpayers pay first for the building and operating costs as part of their taxes; again in
hospital fees and services they use on an as-needed basis; and also in the
health or major medical insurances they all must pay by law to either the
government or to private and local insurance companies.

Staff at the two
hospitals number over 1500. Bermuda has audiologists, chiropodists, chiropractors, dentists, dental technicians,
dieticians, medical doctors. There are also emergency medial technicians, medical laboratory
technologists, midwives, nurses with SRN status or
equivalent or enrolled, occupational therapists, optometrists and opticians, dispensing
opticians, pharmacies, pharmacists, physiotherapists, radiographers
and speech-language therapists. Under
the Nurses Act 1969, all nurses, whether registered (SRN or equivalent) or enrolled, are required to
renew their licenses on an annual basis. The Medical
Program at KEMH has an Annual Review and Awards Ceremony, sponsored by
the Bermuda-based prominent international corporation Merck Sharpe and
Dohme. It provides thousands of dollars a year in awards as part of a commitment to
Continuing Medical Education at KEMH.

2015. June 26.
Much-anticipated financial details have been released by the Bermuda Hospitals
Board (BHB), showing some success in cutting costs. In a guardedly
optimistic assessment, BHB chairman Jonathan Brewin said that two years ago BHB
had expected to run out of cash by the end of 2013, but has now extended the
deadline “well into this fiscal year.” Mr Brewin will step down as chairman
at the end of this month, to be replaced by Peter Everson. While the accounts
summaries up to March 31 of this year are not audited, they offer a snapshot of
BHB’s “evolving” financial position, including:

• Total assets as of March
2015: $587 million, up from $500 million for March 2014;

• Total revenue: $299 million,
down from $312 million in 2014;

• Total expenses: $284 million,
up from $282 million in 2014;

• Excess revenue over expenses:
$13 million for 2015; $15.5 million for 2014

Mr Brewin said the revenue
figures represented a small surplus that did not represent a profit, but rather
money used to reinvest. BHB has cut $24 million from its wages and benefits
costs through attrition, a wage freeze and senior management restructuring. Mr
Brewin added that BHB now has a second oncologist, Dr Christopher Fosker, to
boost its cancer services. Meanwhile, parts of the old Continuing Care Unit are
coming up for demolition, and Mr Brewin thanked staff for the safe transfer of
residents to other parts of the hospital. Quality indicators for BHB are to be
released in the first week of July, as the organization marks its first ever
Hospital Week.

2015. July 2. A contractor
involved in the construction of the new hospital wing has raised concerns about
the standard of fire stopping carried out on the project. Rammy Smith claims
under qualified workers were used on certain parts of the new building to meet
the deadline for its opening. Mr Smith’s firm, Bermuda Coatings Company
(BCC), was hired by BCM McAlpine to supply and install the fire stopping for the
new Acute Care Unit at King Edward VII Memorial Hospital. He has written to the
Bermuda Hospitals Board (BHB) and BCM McAlpine outlining his concerns about the
standard of work done, but both have refuted his claims. The hospital says it
has been reassured by Paget Health Services that all the work undertaken on the
building has been to appropriate standards, while BCM McAlpine said it was
confident that all work on the new wing had been completed properly. Mr Smith
told The Royal Gazette: “We will not and cannot sign off or certify this
project unless and until those areas in question are all identified and
rectified and brought up to code as detailed in Underwriter’s Laboratory (UL)
designs. “I would like the record to show that neither BCC or our suppliers,
Specified Technologies Incorporated, will be or can be held responsible in the
event of a fire. UL designs are independently tested and strictly monitored and
this is for a reason. The general contractor must be held accountable,
especially in light of being a public-private partnership and a public building,
designed and built to save lives. I do not make these accusations without base
or lightly. This is a matter of public safety and the public should be
concerned.” Mr Smith is urging the Bermuda Fire and Rescue Service to conduct
a further inspection of the property. “I am in no way calling into question
the professionalism and intent of the Bermuda Fire Service, who have done and
always have done a good job. We have a great relationship, which is still
intact. I find it odd that no one from my team was asked to be present during
final inspection.” Mr Smith provided photos to this newspaper which he claims
show substandard work that was not completed by his firm. He says that his
firm’s BCC tag is present on materials because his company was responsible for
sourcing the materials, but not the work that has been completed. But Michael
Ewles, chief executive officer and vice president of BCM McAlpine told The Royal
Gazette that all fire stopping work had been completed to the required
standards. “There have been several claims made by Mr Smith which we believe
to be unfounded and these are the subject of ongoing legal proceedings. BCM
McAlpine is confident that the works carried out at the KEMH redevelopment were
completed to the required standards and all work has been inspected and passed
for occupancy by the relevant Bermuda statutory bodies. While there is little we
can add due to the ongoing legal process, we do note that the fire stopping at
the KEMH redevelopment is one of the first projects in Bermuda to individually
tag every penetration within the facility. This new process was instituted by
BCM McAlpine to assist with the quality and compliance of the fire stopping.
Every penetration on both fire-rated walls and non-fire-rated walls were tagged
in the same manner, as we utilized the same materials and details for acoustic
penetrations in the non-fire-rated walls. It is important to remember that not
all walls within the new Acute Care Wing are fire-rated walls and are not
subject to UL design requirements. Of the photos referenced by Mr Smith, two
clearly show tags that demonstrate that the work was carried out by Bermuda
Coatings — Mr Smith’s company. Any penetrations completed by our own forces
were tagged as ‘BCM’. Further, neither of the two photos whose tags can be
identified are in walls which require a fire rating under the National Fire
Protection Association of Bermuda Building Codes. There is no tag visible on the
third photo, so we are unable to determine its location.” A Bermuda Hospitals
Board spokesperson said: “Paget Health Services (PHS) is responsible for
ensuring there is appropriate fire-stopping in the new Acute Care Wing that
meets Bermuda codes. BHB received the letter from Bermuda Coatings Company
Limited recently and forwarded it to the General Manager of PHS. We have been
reassured that all work undertaken has been to appropriate standards, and has
been checked and certified as required by Bermuda law.”

2015. June 1. The
cost of the hospital’s new acute care wing is about to be passed on to
consumers through higher premiums, as the price of the Standard Hospital Benefit
goes up by more than ten per cent this month. The Standard Health Premium
(SPR) is set to rise from $301.85 a month to $338.07 — roughly two thirds of
which will go to the Bermuda Hospitals Board (BHB). The cost for this mandatory
minimum benefits package, which is being renamed the Standard Health Benefit, is
borne equally by employers and their staff, meaning the hike of $36.22 will be
split each month. Announcing new health insurance amendments at the last sitting
of Parliament, Jeanne Atherden, the Minister of Health, said that $23.64 of that
increase would go towards addressing the “crisis of funding” confronting the
BHB. The transfer, which will generate an estimated $13.7 million, will spare
the hospital from increasing its fees — although a 1 per cent increase in BHB
fees also lies ahead. The premium is set by Parliament rather than the BHB, and
is based on annual actuarial recommendations. The SPR has risen steadily over
the years, although it dropped substantially last year from $325.84 — a first,
according to Ms Atherden. The premium was set for $271.61 in the 2013 fiscal
year, and $252.27 in the 2012 fiscal year. The latest increase, which is a 12
per cent rise, is the sharpest in recent years: the SPR went up by a little less
than 8 per cent in the 2012-13 increase — although actuaries at the time had
recommended a 19 per cent increase — and rose by 6.8 per cent in 2011.
Although hospital costs constitute the bulk of the SPR increase, other factors
contribute: $6.17 is expected to be added by a pilot programme offering primary
care to uninsured indigent patients and persons on Financial Assistance who
receive the Bermuda Government’s Health Insurance Plan (HIP), in cases of
chronic disease such as diabetes and high blood pressure. An extra transfer to
HIP, which the minister described as “severely compromised” as the insurance
plan of last resort, will add $4.40 to the SPR, while a transfer to cover
regulation costs for the Bermuda Health Council will add 33 cents. Other changes
to standard benefits have taken a little more than a dollar off the SPR —
including a switch in mammogram screening to United States guidelines, a move
that has come under fire from the Progressive Labour Party.

2015. March 28.
An impending $40 million to be paid for the new wing of King Edward VII Memorial
Hospital in the coming fiscal year has many in the community wondering who will
be called upon to pay.
However, even though the Bermuda Hospitals Board (BHB) is out of cash, and the
Bermuda Government is on an austerity budget, hospital charges are not set to
rise. Jennifer Attride-Stirling, CEO of the Bermuda Health Council, said there
had been encouraging signs that the imperative to cut costs had a positive
impact in 2014-15. “For example, the Home Medical Services Benefit, which was
implemented with great cooperation from BHB to redirect patients from acute care
to the community, resulted in health system savings. Revisions to the
standard benefit package for 2015-16 are being targeted to reduce unnecessary
hospital stays, which should bring down claims and health spending.” In the
wake of ominous revelations this month by Jeanne Atherden, the Minister of
Health, Ms Attride-Stirling said her council was collaborating with the
minister, BHB and others to roll out the new benefits later this year. Giving a
grim appraisal of the hospital’s financial straits, Ms Atherden said it would
be “unfair” for the public to benefit from new health facilities without
expecting any additional charges. A BHB spokeswoman pointed out that the
hospital’s predicament was nothing new. “The financial shortfall that was
commented on in the minister’s budget brief and has been discussed publicly by
BHB for two years. BHB’s plans to address this shortfall do not include
significant fee rises, but focus on improved efficiency and effectiveness
internally and supporting improved public health to reduce the need for all
healthcare services. BHB is committed to do all it can to make the necessary
changes to meet its obligations.” BHB does not set its own fees or add new
ones without Parliament’s approval, and the spokeswoman affirmed that there
had been a consensus that the Island “cannot afford significant fee
increases.” The BHB chairman, Jonathan Brewin, announced in February that the
organization had launched a formal Modernization Project — not merely to cover
its monthly payments for the new acute care wing. BHB will continue to invest in
its services, along with maintaining the ageing facilities at the Mid-Atlantic
Wellness Institute and the general wing of KEMH, even as the costs of drugs and
equipment continue to rise. “Achieving financial sustainability requires
change in how we operate and work, and could reshape our service profile, but
our focus will be on protecting the safety and quality of front line services
and maximizing our effectiveness and efficiency,” the spokeswoman added. “It
is important to note that hospital fee increases alone do not drive premium
increases. Cutting BHB costs alone does not resolve the hospital or the
country’s challenges around healthcare premiums. Premiums pay for all
healthcare costs — and 56 per cent of costs are not hospital related. “The
biggest driver is utilization across all local and overseas services. For the
country to address premium costs, we need to look at public health, better
prevention and management of chronic diseases, as well as better coordination
and collaboration throughout the healthcare system. Even when there has been no
increase in hospital fees, such as in 20013/14, healthcare premiums have still
gone up.”

2015. March 19.
The number of patients receiving dialysis treatment at King Edward VII Memorial
Hospital has risen by 207 per cent in a little more than decade — and is
expected to increase further. The facility is treating 166 patients, compared
with 54 patients in 2002 and 2003. The annual cost of dialysis treatment is
about $200,000, which does not include the medication, consultations and cost of
other complications an unwell patient might have. A hospital spokeswoman, who
gave the figures, confirmed that the number of patients had risen during the
building of the new Acute Care Wing, where the stations are housed. “In 2009
[when the specifications for the new building were developed] the year-end
census was 103, although it was anticipated this number would rise,” said the
spokeswoman. According to the National Kidney Foundation in the US, dialysis is
needed when a person has lost about 85 to 90 per cent of their kidney function.
It removes waste, salt and extra water, keeps a safe level of certain necessary
chemicals in the blood, and helps to control blood pressure. “We had 19
stations in the old unit, which were much closer than in the new unit,” the
spokeswoman said. “We now have 22 stations and can do 16 more treatments per
day than in the old unit.” She said they operated for longer hours, from 4am
to 9pm, Monday to Saturday. According to medical professionals, about half of
Bermuda’s dialysis patients suffer from uncontrolled hypertension and a
significant proportion of the remainder have diabetes. The high cost of
healthcare arose in the House of Assembly during debate on the Budget focusing
on the Ministry of Health, Seniors and Environment, which finished in the early
hours of last Tuesday morning. Health Minister Jeanne Atherden told MPs: “The
issues surrounding chronic disease management, in particular diabetes, continue
to put enormous strain on the Bermuda Hospitals Board. “Dialysis services are
projected to grow and, on the hospital’s current best estimates, at a rate of
9 per cent by the end of the current fiscal year and by up to a further 10 per
cent in the year 2015. The Bermuda Hospitals Board is entitled to be paid fairly
for all the services which it properly provides, but it has continued to provide
care even when payment has not been possible and this impacts its revenues. On
many occasions during the last year, the Bermuda Hospitals Board has also
provided skills and experience, facilities and equipment, to assist with
national issues at no charge, and it will continue to fulfill this public
commitment. But to do so, the Bermuda Hospitals Board has to carefully manage
its resources to ensure that its core mandate of providing acute care services
is not endangered. In short, choices have to be made and if the funds are not
there, these additional “free of charge” services will no longer be able to
be provided.” Dietitian and diabetes educator Sara McKittrick, of the Bermuda
Diabetes Association, said: “We estimate there are a minimum of 8,000 to 9,000
people living with type two diabetes, which is linked to genetics, lifestyle and
obesity. There are also fewer than 150 patients with type one diabetes, which is
not linked to obesity or lifestyle. As many as 18 to 20 per cent of the
population are affected by diabetes if we include those with pre-diabetes. Type
two diabetes rates in Bermuda are huge and that dealing with the issue is an
uphill battle. It’s to do with poor dietary habits, sedentary lifestyles
and the genetic predisposition. To reduce the burden of diabetes, intervention
is critical for those at risk to delay or prevent the development of the
disease. Any programme you put into place to prevent diabetes will help that.”
In a speech to the Hamilton Rotary Club last September, Dr Michael Weitekamp,
the chief of staff of the Bermuda Hospitals Board, said that the Island had one
of the highest healthcare costs per capita at $10,562, according to the National
Accounts in 2012. But he said there was little to be proud of in the health
outcomes, noting that Bermuda has one of the highest global rates in obesity,
diabetes, dialysis and limb amputation, as well as a high incidence of road
traffic accident deaths and life-altering injuries. He said that socioeconomic,
environmental and behavioral determinants of health took a back seat to acute
interventions, and added that under investment in socioeconomic, environmental
and behavioral spheres comes back to haunt Bermuda in the form of higher
spending on acute care interventions.

See above story

2015. March 11.
The Bermuda Hospitals Board is expected to run out of cash “in the near
future” — and must find $40 million to pay for additional costs owing to the
new acute care wing during the coming fiscal year. Minister of Health,
Seniors and Environment Jeanne Atherden told the House of Assembly on Monday
evening that the BHB has major financial challenges. Speaking during the budget
debate, she said: “Last year the minister reported on the dire financial
situation being faced by Bermuda Hospitals Board. It was, at that time,
predicted that Bermuda Hospitals Board would run out of money in the current
fiscal year. This clearly was not an acceptable position so it worked hard to
manage its cash and prolong, as far as possible, the time when it would become
cash delinquent. The minister said that measures were put in place rapidly. A
ten per cent reduction in operating expenses was successfully implemented in the
last fiscal year, and a 15 per cent cut was put in place for this fiscal year.
The Bermuda Hospitals Board is well on its way to achieving this. However,
financial pressures are increasing. On top of monthly payments of over $2
million per month for the new acute care wing, Bermuda Hospitals Board has
responded to the national financial crisis the Government is dealing with, even
though this has significantly reduced its revenues. Last year, the Bermuda
Hospitals Board forecast it was going to run out of money at the end of 2014. It
has taken all the steps it can, and while it has been able to postpone this day,
at some point in the near future cash will be exhausted. The BHB faces further
problems. In the coming year there are some uncertainties which will have to be
managed. The coming on stream of the new acute care wing is a very welcome event
for the country as a whole, but as we all know the facility will have to be paid
for. The additional costs per annum of the new acute care Wing to the Bermuda
Hospitals Board will be in the order of $40 million. This amount is too great to
be absorbed by the Bermuda Hospitals Board and it’s unfair for the public to
expect to benefit from the new facilities without any additional charges. The
Bermuda Hospitals Board, the Bermuda Health Council and my ministry are
carefully examining the options with a view to bringing forward proposals
shortly.” Ms Atherden said that hospitals around the world face the same
difficulties that the BHB is facing. “What is different is that the Bermuda
Hospitals Board delivers Bermuda’s only medical and mental health hospital
services. It has to provide a wider range of services to the community than most
other hospitals as there are no other options, and it is the place of last
resort for people who cannot get access to healthcare anywhere else.”

2015. February 6.
For the first time in the history of King Edward VII Memorial Hospital, the
maternity ward is now equipped with two modern operating rooms, Bermuda
Hospitals Board has announced. Dale Wilmot, BHB’s chief of obstetrics, hailed
the completion of the two ORs as a great step forward in improving the safety
and comfort of mothers, along with their newborn children. One room will
function solely as a state-of-the-art OR for both planned and emergency
Caesarean sections, with the second room retained for routine deliveries but
fully equipped as a backup OR. Both rooms are next to the birthing rooms, making
it easier for mothers in need of emergency interventions. Previously, when
mothers required emergency C-sections, they had to be transported to a level
above the delivery rooms.

2014. October 17. Both the old
and the new wing of the King Edward VII Memorial Hospital have been breached by
Hurricane Gonzalo, the Emergency Measures Organization announced at 9.30pm,
resulting in leaks and water damage in the facility. Police spokesman Dwayne
Caines reported that the hospital had sustained roof damage during the storm —
but said that contingency plans for such an event had been enacted by KEMH
staff.

2014. August 25. A surgical
first for Bermuda could help a hospital patient paralyzed from the neck down
breathe on his own. And that means the young man — who has been in the
King Edward VII Memorial Hospital for several years after an accident and can
only breathe with the aid of a ventilator — could be discharged home. KEMH
doctors flew US medic Dr Raymond Onders, a Professor of Surgery in Cleveland,
Ohio, and an world-renowned expert in the procedure, to supervise local surgeons
Dr Boris Vestweber and Dr Herman Thouet. Dr Onders said: “The team at the
hospital was tremendous. The operation could not have been done better anywhere
else in the world.” A report in the Bermuda Hospitals Board’s in-house
magazine explained that it was more cost-effective to bring Dr Onders to the
Island, rather than transport the patient to Ohio. Hospital chief of geriatrics
Dr David Harries said: “It is hoped the patient will be able to make do
without his ventilator completely. The plan for him to be eventually discharged
and cared for at home.” The technique — called diaphragmatic pacing —
involves surgeons attaching electrodes to the patient’s diaphragm, with wires
leading out of the body to a pacemaker, which uses electrical impulses to
contract the diaphragm, allowing the patient to breathe. And chief nursing
officer Judy Richardson said the family of the man — who has not been named
— were “extremely happy” that the surgery could be performed in a familiar
environment by staff they know and trust.

2014. June 13. The Bermuda Hospitals
Board (BHB) officially received the key to the new Acute Care Wing yesterday in
a ceremony at King Edward VII Memorial Hospital. Final building work at the
site is still ongoing but BHB CEO Venetta Symonds said the event marked a key
point in preparing the facility for its grand opening in September. “Having
the key allows our engineers to now come in and do connecting work and it allows
contractors to fine tune everything in the building,” she said. “Staff also
need to get oriented and training so that we have a smooth move over in
September when we open to the public. The 90 beds in the new building will
replace beds in the old building and will be used for everyone in need of
medical or surgical care.” In addition to the new acute care beds, the new
wing will house emergency, diagnostic imaging — specifically the x-ray,
ultrasound, MRI and CT scanning equipment — day surgery, dialysis and
oncology. Around $300 million have been spent on the project to date, between
the construction and design costs paid by Paget Health Services and the sum BHB
has paid for equipment. BHB Chairman Jonathan Brewin said the project has
remained on budget, as the payments and costs were set out when the contract was
signed. The Bermuda Hospitals Charitable Trust, who set out in April 2011 to
raise $40 million through the Why It Matters campaign, has so far raised around
$31 million of its goal. Alan Burland of BCM McAlpine said he was very proud of
the project, calling it both a key pillar for Bermuda and a demonstration of the
potential of public-private partnerships on the Island. “This has been a huge
achievement,” he said. “This is the largest project ever done in Bermuda.
This has truly been a massive and effective team effort, and I have to stress
team. It’s a rich blend of locals and expatriates that brought this to
fruition. We couldn’t have done it without the combined team, and you should
all be justly proud. It demonstrates world class infrastructure, and is really
unrivalled on any other Island.” Premier Michael Dunkley described the
handover as a milestone for Bermuda, saying: “It’s a day which marks a
pivotal moment in the history of healthcare on the Island.” He thanked all of
those who have worked to make the new facility a reality, saying that the
project took a lot of planning, preparation and skilled labour to bring to
fruition. And newly named Minister of Health, Seniors and the Environment Jeanne
Atherden said: “It was just a few weeks ago that I was a member of the board
and so I’m well informed of the need for this facility and it’s importance
for the healthcare of Bermuda. This is an important milestone but I must remind
you that this is not the end of the journey. There is still serious work to be
done and in the next three months we have to ensure that there’s a safe and
seamless transition of patients and services and we have to prepare the staff
for the new standards of care that the BHB will be able to give to patients at
this new facility.”

2014.June 12. An
American oncologist hired two years ago to lead Bermuda Hospitals Board's cancer
services is to exit the Island in September and is currently on sick leave,
leaving only part-time doctors to cover his absence. The departure of Paul
Coty from King Edward VII Memorial Hospital raises concerns for Bermuda's cancer
sufferers, according to a source, who yesterday questioned how quickly a
replacement would be found and how appointments would be covered in the
meantime. Dr Coty, originally from New York, came to Bermuda in February 2012 as
KEMH's only full-time oncologist, after spending eight years in Hawaii. A BHB
spokeswoman confirmed to The Royal Gazette yesterday that he was due to leave
the hospital in September and said his position was advertised many months ago.
"We will hopefully have good news about his replacement in the near future,
but until details are finalized we cannot provide further details. We can assure
the Bermuda community, however, that we remain committed to ensuring our
oncology patients are cared for and will do all that is necessary to ensure that
consultations and treatments are not interrupted during this time of
transition." The spokeswoman said Dr Coty was currently on unplanned sick
leave, which was expected to be over by the end of June, and she apologized to
KEMH's cancer patients for ?this unexpected disruption and for the rearrangement
of their consultations. The source, who asked not to be named, told this
newspaper there were concerns about how quickly Dr Coty's patients would be seen
in his absence and how long it would take to replace him. "This is the same
situation they were in about three years ago and it took them a year-and-half to
find someone," said the source. "The problem today is that a lot of
oncologists are specialists and it's very hard to find a general one, which is
really what Bermuda needs." Those comments echo remarks made in 2012 by
BHB's chief of medicine, Keith Chiappa, when Dr Coty was appointed. Dr Chiappa
said the hospital required a full-time oncologist. "As cancer patients and
their families in Bermuda are aware, over the last few years we have been
working hard to appoint a full-time, high quality oncologist. The global
shortage of specialists in this area has made it especially challenging."
The source added yesterday that Dr Coty's current absence and his imminent
departure raised two main concerns. "Patients who are already diagnosed,
you have a trusting relationship with your oncologist and that's now been pulled
away. For anybody newly diagnosed, the next person you see is the oncologist.
They are the one who will look at your case and meet with the tumor registry if
necessary. They are the one who recommends what happens next, be it surgery,
chemotherapy or radiation. That's your lifeline as a cancer patient." The
BHB spokeswoman said oncologists Tutu Aung-Hillman and Jean Walters, who have
both worked at BHB before, were assisting with part-time temporary coverage. She
said Dr Walters would arrive by the end of the month, as she had other
commitments until then. "Dr Walters is working one week a month and has
agreed to cover Dr Coty's vacation before he leaves. Dr Tutu Aung-Hillman will
be working three extended days [a month] while Dr Coty is away. We are also
working closely with our clinical associate to ensure appropriate coverage. We
are very grateful for the assistance of Partners Healthcare System in ensuring
oncology services in Bermuda. Although not directly employed by BHB, there is
also a visiting genito-urinary oncologist, Dr Mary Ellen Taplin, from the Dana
Farber Cancer Center (part of Partners), who regularly visits Bermuda to see
patients with prostate and other related cancers. Dr Taplin will continue to
visit, as will the four Lahey physicians who see patients requiring radiation
therapy for breast, prostate, gynecological, head and neck cancers. At the
moment, new oncology patients are individually assessed and, between our locums
and the ability to refer overseas in urgent cases, oncology needs are being met,
meaning that patients continue to receive effective consults and
treatments." There were more than 200 registered cases of cancer in Bermuda
in 2012, according to the most recent National Tumor Registry annual report.
Bermuda Health Council says cancer is the second leading cause of death in
Bermuda, accounting for more than 30 percent of all deaths in 2009.

2014. June 11. AXIS Capital
has donated $1 million to the Bermuda Hospitals Charitable Trust (BHCT),
bringing the group’s funds to $31 million. The new acute care wing at King
Edward VII Memorial Hospital will require a $40 million payout to contractors
Paget Health Services upon its completion. The “Why it Matters” campaign by
the BHCT has been raising money since April 2011, and is now in what executive
director Ralph Richardson called “the home stretch”. AXIS chief executive
officer Albert Benchimol said the company was committed to helping deliver
“deliver enhanced and affordable healthcare” to the community. Thanking the
company, BHCT chairman Philip Butterfield said the donation put the campaign
“one step closer to achieving our goal of providing a world class standard of
excellent healthcare through modernized facilities”.

2014. May 6. The contract on
Bermuda's new hospital wing has resulted in substantial losses for a major UK
construction firm, according to The (Daily & Sunday) Telegraph, one of the
UK's most prestigious newspapers. However, the Bermuda Hospitals Board (BHB)
last night responded to that the project remained squarely on budget. The
British newspaper yesterday
reported that Sir Robert McAlpine Holdings has reported a pre-tax loss of
37.7m for the financial year ending October 31, 2013 versus a 19.2m profit
reported for the previous year. The company, which was behind the London 2012
Olympic Stadium, has been left deep in the red on the £ sterling 176 million
contract for the acute care wing at King Edward VII Memorial Hospital (KEMH).
McAlpine Holdings is described as the umbrella company for the family's
construction portfolio. Operating profits declined from 17.4m in 2012 to a loss
of 40.2m. Company directors ascribed the fall in takings to the company's
support for the Bermuda-registered BCM McAlpine Limited, which is the main
contractor for the project. Severe problems with design and performance caused
losses that were covered by a 50m stipend fronted by Sir Robert McAlpine
Holdings. The Telegraph quotes company director Ian McAlpine as saying business
was severely impacted by the difficulties encountered on the King Edward VII
redevelopment. The construction of the new acute care wing is the Islands first
public-private partnership, between BHB and Paget Health Services. Paget Health
is a consortium of local and international companies, charged with building,
financing and maintaining the new hospital wing over the next 30 years. Under
the arrangement, cost overruns are to be carried by the contractor, and not by
BHB. According to the UK newspaper, BCM McAlpine has significant claims
outstanding from the project and owed the holding company 18.8m as of October 31
last year. The new acute care wing, originally slated for completion in March,
is currently projected to be completed by mid-September of this year. A BHB
spokeswoman said the organization had no comment on The Telegraph's story,
adding: "The new wing is on track to be completed on budget and to the
contracted quality standards and specifications. We look forward to opening our
doors to the public this September."

2014. April 17. The healing
power of natural light played a major role in the architectural design of King
Edward VII Hospitals new Acute Care Wing. Offering an update on the
construction of the Wing yesterday, a hospital spokesperson said large windows
were featured throughout the building. And while that allows light into areas
facing outdoors it doesn't address areas in the middle of the new facility. Yet
natural light pours as readily into these areas as those on the perimeter of the
building. "This is because a central atrium with skylights has been created
in the middle of the facility," said the spokesperson. Bermuda Hospitals
Board president and CEO Venetta Symonds added: "The design in this section
of the building uplifts your spirit. I'm sure members of the public will
especially appreciate having this feeling in a hospital setting." The
functionality of making it a waiting area speaks to the expertise of the
architectural and design team of Paget Health Services. The atrium is 2,738
square feet on the second floor. It houses a waiting area, check-in desk and
discharge lounge for surgical patients. The waiting area seats 18 people while
the discharge lounge seats eight. According to the spokesperson, scientific
studies have proven the importance of lighting levels on mood and emotion and
more recently on the body's circadian rhythms and in turn, its physiology. The
Bermuda Hospitals Board is proud that the new Acute Care Wing provides both its
staff and the public with healthy amounts of natural light. The Acute Care Wing
will open to the public in September. Those willing to support new Wing with a
donation to the Why It Matters campaign can visit www.bhct.bm
for more information.

2014. February 10. Government
has kept quiet on plans to curtail high-cost diagnostic imaging but the hospital
has defended itself against claims by local physicians that it has been the main
culprit for spiraling healthcare costs. Pre-certification, which requires
doctors to get a second opinion, is aimed at cutting down on the frivolous use
of procedures such as MRIs and CT scans. The
imaging tests cost thousands of dollars and come with their own health risks: CT
scans deliver significant doses of radiation. A
Health Ministry spokeswoman said Government was working in tandem with the
Bermuda Health Council to realize a public information paper on the rationale
and workings of pre-certification. The
focus will be on diagnostic testing, which includes medical imaging and clinical
labs, and the intent is that before such procedures can be carried out, they
would have to be pre-approved by an authorized entity, based on standardized
medical guidelines, she said, adding that more information would be released in
due course. Details on how
the scheme would be implemented in Bermuda, such as whether pre-certification
would take place by phone or online, have yet to be revealed. Pre-certification
is common in the US managed healthcare system and similar procedures are
employed under the UK's National Health Service as the soaring cost of
healthcare leads to rising insurance premiums. Bermudas
healthcare system is second only to the US for year-on-year increases that were
branded unsustainable by Government three years ago. Physicians
have attacked Governments rationale for introducing the system to the Island. Pre-certification has been denounced
as an onerous extra expense that will put patients at risk and doctors who spoke
anonymously with The Royal Gazette maintained that unnecessary testing was more
the fault of the hospital than the local medical community. However,
according to the Bermuda Hospitals Board (BHB), close to 60 percent of the MRIs
and CT scans carried out on the Island come from the community itself. Bermuda
residents receive more of the tests than fellow Organization for Economic
Cooperation and Development (OECD) states, MRI exams in particular and
conservative estimates show overuse costing our healthcare system well over $4
million annually. A BHB
spokeswoman said the hospital was mandated under law to offer essential
equipment, which hospital-based doctors used in the community's best interests. BHB does not receive additional
revenue for tests performed on in-patients or emergency patients who are
ultimately admitted to hospital, as all hospital services are covered under a
fixed diagnostic related group charge for their inpatient care, she added. BHB also provides services to
outpatients who are referred to the hospital for tests by community physicians.
These referrals often include diagnostic imaging or laboratory tests. BHB
performs these tests and bills the patients insurers accordingly. She
acknowledged that the hospital has come under fire in the debate over the
Islands increasingly precarious healthcare system. Blame
is frequently assigned to BHB for running up health costs when the reality is
that a substantial portion of BHB's annual revenues arise from community
physicians referring patients for outpatient diagnostic imaging and laboratory
work, she said. According to
a December 2012 survey of MRI and CT tests performed at BHB, 56 percent of the
tests were on behalf of community physicians. A
further 28 percent were ordered by BHB emergency physicians, and 16 percent by
other BHB physicians. If we
assume all tests ordered by community physicians are medically necessary and
appropriate, they would be a cost to the health system regardless of whether
they are performed at the hospital or another diagnostic centre, the spokeswoman
added. And Bermudas high
usage of both tests was established by the same survey. Collectively,
local doctors order 138 CT exams per 1,000 residents to be performed at BHB
compared to the OECD average of 131. Seventy-nine
MRI exams per 1,000 residents are performed at BHB compared to the OECD average
of 46. Using this data and
the price per test, the cost of Bermudas excess utilization can be extrapolated
as $4.2 million per annum, she said. It is key to note that these figures
exclude MRI and CT tests performed at other local diagnostic facilities and
tests performed overseas, so the potential overspend is likely understated. Any initiative to manage healthcare
would have to consider both BHB and community physicians in order to rein in
medically unnecessary testing and costs, she said.

2013. December 2. The
salaries of hospital officials, which the One Bermuda Alliance pledged to make
public, will not be released until hospital financial statements have been
audited. Responding to Parliamentary questions by Opposition MP Lovitta
Foggo, Health Minister Patricia Gordon-Pamplin said the information would be
released in the Bermuda Hospitals Board annual reports. However, BHB financials
remain unaudited for 2011/12 and 2012/13. The Minister also reported nearly
$400,000 in savings had been realized by the Lamb Foggo Urgent Care Centre in St
David's since BHB reduced the facility's working hours in April. The centre
saved $196,523 on salaries, with an additional $200,000 saved on security
services, Ms Gordon-Pamplin told the House of Assembly.

2013. November 29. A medical
services subsidiary of the Bermuda Hospitals Board was dogged by serious
concerns since it was created, Health Minister Patricia Gordon-Pamplin told
MPs. Healthcare Partners Limited (HPL) had problems with governance and its
overall operations from its September, 2008 inception, according to a review by
the Department of Internal Audit. BHB announced in July that the subsidiary
would be dissolved by the end of the current financial year. "The
review found that as a result of an unclear operational purpose for HPL, the
auditors were not able to determine how HPL fit into BHB's operational model and
strategy," said the Minister. The auditors therefore could not determine
the true organizational impact of HPL's existence on BHB's operations, or
whether HPL was achieving its intended purpose. HPL was set up to generate
revenue through public private partnerships, as well as providing BHB with the
flexibility to provide enhanced medical services but it failed to live up to its
financial expectations. HPL's physician billing business will transfer to the
hospital's financing directorate, while the money-losing Medical Concierge is
under review to see if the service can be retained by BHB. The subsidiary's
third business unit, Ultimate Imaging Limited, is still in discussion with the
board to allow HPL to be dissolved, the Minister said.

2013. November 22. A
further $10 million in fundraising is needed to cover a $40 million payment for
Bermuda's new hospital wing before next year's impending deadline. However,
Health Minister Patricia Gordon-Pamplin said she was completely optimistic and
confident that the campaign by the Bermuda Hospitals Charitable Trust (BHCT)
would reach its goal. BHCT launched its Why it Matters campaign in April 2011 to
raise the capital due from Bermuda Hospitals Board (BHB) to project investors
Paget Health Services. The money must be paid upon the completion of the new
medical facility originally slated for April 1, 2014. BHB is liable for covering
any shortfall in that one-off payment. Asked about backups in place for
cash-strapped BHB which Chairman Jonathan Brewin has said might slip into debt
by the end of the current fiscal year the Minister said: "While there is a
contingency plan in effect, we are focusing on the positive, and will roll out
that alternative plan should the need arise." Ms Gordon-Pamplin recently
announced a slight delay in the April 1 deadline, which she said would allow the
BHCT extra time to solicit donations for the cause. A spokeswoman for the Trust
said the group had so far raised almost $30 million, and was confident of
meeting its objectives. "At this time, we are solely focused on fundraising
and will continue to rally support from companies, organisations and
individuals. This is our Island and our hospital, and we all have a stake in the
game." And a spokeswoman for BHB pointed out that the construction project
for the $247 million hospital wing is backed by a Government guarantee. BHB
Chairman, Mr Brewin said: "BHB has been very conservative in its planning
to ensure both best case and worst case scenarios are prepared for. In terms of
the one-off payment, we still have every confidence there will be a successful
fundraising campaign where the generosity of individuals, families and companies
of Bermuda are able to donate $40m. But we have potential plans should this not
materialize and through careful planning and discussion with the BHCT and
Government, we have a number of options to help us meet our obligations. We will
continue to work closely with our partners and remain extremely grateful for all
donations received. Every dollar raised helps healthcare and Bermuda." The
$40 million one-off payment signals the start of an expensive year for BHB, as
outlined for Wednesdays Senate by Junior Health Minister Lynne Woolridge. She
said that Paget Health Services (PHS) was committed to maintaining the new
hospital wing over the next three decades but added BHB will face significant
payments. In the first year, the monthly payments to PHS are about $2.5 million,
Senator Woolridge said. On top of this, BHB must cover general running costs
such as staffing and cleaning costs which Sen Woolridge described as
substantial. After the first year, 70 percent of the payments to PHS will remain
fixed with the other 30 percent subject to variables such as inflation and
insurance. This means there is significant pressure on BHB to manage the
contract well, to ensure it is adhered to, and BHB is putting the necessary
management arrangements in place, Sen Woolridge said.

2013. November 20. The
Bermuda Hospitals Board will consider bringing Mid-Atlantic Wellness Institute
(MAWI) services to King Edward VII Memorial Hospital. The suggestion was one of
several made recently by the SAGE Commission, who said the MAWI site could be
sold off rather than spending $40 million to renovate the Devonshire facility. A
spokeswoman for the BHB said: "The board is looking at every way it can to
run more efficiently while maintaining safe, quality services. MAWI is an ageing
facility and a recent review of the MAWI estate estimates that a $40 million
investment would be needed over time to maintain and upgrade its infrastructure
and ensure it can continue operating as a psychiatric facility. We are currently
reviewing the delivery of BHB services, and our Senior Management Team and Board
will certainly consider the opportunities in consolidating the two sites in more
detail as part of this process." The SAGE Commission Report, released on
Friday said: Duplicated services are provided at the King Edward VII Memorial
Hospital and at MAWI because the two facilities are operated on two separate
sites. Substantial savings would be generated from operating both facilities on
one site. It also suggested the BHB examine the possibility of erecting a new
building adjacent to the acute care centre already under construction to house
both psychiatric services and continuing care facilities for the elderly.

2013. July 16. A
“fee-for-service” billing system at King Edward VII Memorial Hospital is
being reviewed by health chiefs who claim that it “incentivised” physicians
to carry out tests and invasive examinations on patients in order to increase
the hospital’s revenue. And even terminally ill hospital patients may have
undergone unnecessary medical tests and procedures because of the arrangement,
health advocates claim. The billing system — also known as case-based
reimbursement — was introduced by the former Bermuda Hospitals Board (BHB) in
2009. According to the Board’s website, it is “a fairer, more transparent
way to charge people for services used. It means someone who is admitted to
hospital will be charged based on the type of treatment and services associated
with their diagnosis. Previously, the hospital charged one daily rate, no matter
how many services were needed,” the website added. But Government MPs have criticized
the method, saying that it needs to be re-examined to ensure that vulnerable
patients are not being taken advantage of. And according to one health watchdog,
the process has been “abused to the extent that medical tests were recommended
and used purely as a means to increase revenue.” Backbencher Jeanne Atherden,
who is also chairman of the Bermuda Health Council and a member of the new BHB,
said: “We’re looking at the whole system of charges to see that they are not
being abused. Nobody wants to see duplication or over testing because that can
have a negative affect on the patient. One never wants to have a system that
encourages revenue generation — the emphasis needs to be on patient care and
patient outcomes. If you have incentives for people to generate income, what we
really should have is a system that encourages quality. I have real concerns
when I see salaries that were related to things not related to quality of
care.” She added that the hospital appeared "to place great emphasis on
revenue growth which was very much encouraged. The health council is now looking
at utilization management, standards of care and regulation.” Those concerns
were echoed by Economic Development Minister Grant Gibbons, who said: “You
don’t want somebody paid or incentivised on the basis of the more tests or
more time. What you want them to be compensated on is the quality of the outcome
— how successful has the treatment been and how efficient have you been in
administering that. Pay was connected to utilization which is not good at all.
There was a complete lack of attention to cost control at the hospital.” Last
month the BHB said it was aware “that there is a perception that BHB charges
too much, makes too big a surplus and yet squanders its resources.” We believe
there was not enough focus on cost control at BHB, as its strategy over the last
seven years had been to grow its revenue and increase the number of services
available on Island,” Chairman Jonathan Brewin said in an open letter to the
community. “This contributed to the increasing use of services — utilization
— further driving healthcare costs up.” Last night hospital watchdog the
Bermuda Health Advocacy Group welcomed news of the review, claiming that the
billing system had put dollars ahead of care in the hospital’s list of
priorities. “The premise for change was purely economical and in an endeavor
to increase profit margins,” a BHAG spokesman said. “To date the BHAG has
had numerous complaints from a wide spectrum of the community complaining about
costs and unnecessary procedures.”

2013. July 16. Hospital
watchdog Bermuda Health Advocacy Group (BHAG) has applauded moves by Government
to shut down an ageing hospital wing which provides long-term care to elderly
patients. Health Minister Patricia Gordon Pamplin announced the move last
week, claiming that the Continuing Care Unit at King Edward VII Memorial
Hospital was "no longer fit for purpose". Government is now looking at
alternative facilities to care for some 150 mainly elderly patients, many of who
are suffering from deteriorating mental capabilities. In a statement, BHAG said
news of the closure should come "as no surprise" and that "it was
only just a matter of time before a hard decision had to be made concerning how
to move forward with CCU's mode of operations." Healthcare in Bermuda is
transitioning at an alarming rate and unfortunately the focus objectives are far
removed from concerns in relations to the elderly," the statement said.
"The continuous accusations surrounding the questionable and sometimes
inappropriate level of care for our elderly on that unit was much to be desired
furthermore, the staffing issues was always a point of contention and
controversy. The Bermuda Hospitals Board, for whatever reason, always seemed to
avoid real dialogue when it comes to the concerns and issues plaguing the
infrastructure and level of care associated with their seniors. It is no secret
that families for many years have complained about the substandard care given to
their love ones to the point some of the seniors’ children become part-time
caregivers to their parents as a result of visiting the unit everyday. The truth
be told there is plenty of blame to go around as a result of the disrepair and
neglect of the CCU. BHB along with the previous government should have taken
measures and planned initiatives to task with a strategy that was proactive and
comprehensive over a reasonable duration considering the direction it was
heading. The remised foresight and lack of attention given to the seniors at CCU
is overwhelming evidence to suggest ill-equipped and inexperienced
administration who lacked knowledge and ability capable of such an undertaking.
Bermuda should be embarrassed and ashamed of what has been allowed to transpire
with our seniors. The dignity and legacies of those who helped to pave a better
and bright Bermuda, who no longer have the mental capacity or strength to fend
for themselves, have become a wasted commodity to its people. The Bermuda
Healthcare Advocacy Group could only hope that any endeavor to move forward with
our greatest prize and possession would be done with as much dignity and
compassion available.”

2013. May 18. Bermuda’s
healthcare system is “well above average” for the size of the community it
serves, according to an independent team of inspectors. But the consultants also
listed a number of areas that needed to be improved at King Edward VII Memorial,
including poor facilities, staffing, and a failure by officials to deal with
staff and patient complaints. And the Corporate and Clinical Governance
Review by Canadian company Howard Associates came under fire from Ombudsman
Arlene Brock, who said the company’s report “breezes over the key concerns
that led to the report in the first place”. (See separate story.) The company
spent five months carrying out an assessment of healthcare services on the
Island before submitting its findings to the Bermuda Hospitals Board last month.
“We do not know of any other jurisdiction that provides this high level of
quality, quantity and spectrum of healthcare services for a comparable small
population,” the report concluded. “For those who were expecting a very
‘damning’ report against the BHB, they will be disappointed. Hospitals, as
we stated earlier in the report, are difficult to manage. There is much to be
grateful for BHB including the new hospital wing currently being built. Having
said that, the huge if not enormous challenges voiced by some leading figures in
Bermuda of how to pay for this going forward, are also valid.” The report
added that the range of services provided at KEMH was “strong and
impressive” and added: “In our benchmark comparative, the BHB stands up well
under most metrics to other small hospitals that we know well.” But the
inspectors went on to list a slew of concerns over standards of care — and
also took a swipe at the former board, which was replaced earlier this year by
the new Government, for its management of the hospital. Criticizing the
facilities at KEMH, the report said the hospital “is out of date.” It went
on: “There are too many ward rooms. Modern hospitals have mainly private
rooms. The rooms are far too small to handle modern equipment. Every room should
have a ceiling hoist. We saw very few. Corridors are too small. There is a total
lack of storage space for practically everything. Bathrooms are too small. Door
openings were made for a different era. There is a lack of space for infection
control.” Staff moral at KEMH was “lower than it ought to be”, and the
hospital was not “providing adequate staff recognition and staff rewards. The
stress on staff ... is very high”, according to the review. The report noted
the “lack of clinical, medical and healthcare expertise of the previous Board
members”, adding: “Most stakeholders told us the Board has had problems in
the past with transparency.” And it highlighted concerns over front line
healthcare, with problems in medical and surgical units. It said there was an
over-reliance on junior house officers for patient care and “a striking lack
of peer review for physicians. Over the past five years, BHB did not devote
enough time, resources or effort to measuring quality or to patient safety. Over
the past year there has been a significant improvement in this important
function. Despite the above successes, we believe that more work needs to be
done and some revised modalities should be implemented. We believe all hospitals
must continually strive to improve quality and patient safety and the BHB is no
exception.” The report said that “patient and staff complaints are not
properly addressed by the current BHB system” adding: “To say that patient
complaints fall on deaf ears would be an understatement.” And it concluded by
putting forward ten recommendations for improving services, including the need
to become more transparent, the introduction of a coordinated clinical service
plan, more efficient and effective methods of funding and the better use of
middle managers and front line staff.

2013. May 4. Hospital chiefs
insist they are working to improve the care and conditions of patients suffering
from Alzheimer’s and dementia after visiting experts criticized standards at
King Edward VII Memorial. Yesterday The Royal Gazette revealed that a team
from the UK’s Dementia Training Company inspected the hospital’s facilities
last December. Faults found at the Alzheimer’s and Related Disorders Unit
(ARDU) included the use of restraints to strap patients to chairs, an
“unwelcome” and “clinical” environment, and a lack of “meaningful
engagement” between patients and staff. But, according to the unit’s
director, staff are now implementing recommendations put forward by the
inspectors in an effort to raise standards. And Granville Russell also claims
the hospital is working with the charity Action On Alzheimer’s to ensure that
progress on the ward continues. The charity was responsible for bringing the
inspectors to Bermuda. “We are working on all the recommendations and many
improvements have already been made,” Mr Russell said. “Many improvements
have been made since the review, and we have just this year started a
satisfaction survey. Residents who are able are surveyed, and family members of
patients with dementia and Alzheimer’s are surveyed. We will be measuring the
impact of the changes as they are implemented and listening to the feedback to
ensure we deal with any issues families, and residents, experience that were not
raised by the review. Restraints were only used as a last resort. Our focus has
been on ensuring all staff know the policy and follow it. It should be noted
that ARDU does not have or use ankle restraints. When needed for resident
safety, and only as a last resort, we use posey vests and soft belt restraints.
Staff treating Alzheimer’s and dementia sufferers attended training sessions
last autumn and a full-time activities aide was now employed at the unit.
Activities includes bus rides, spiritual sessions, baking sessions and Friday
movies. We also have plans to better utilize the garden, as recommended in
the report. In the coming months, garden beds on the perimeters of the walkways
will be filled in, new furniture will be provided and a herb garden formed.
Trees overlooking the harbour will be cut back to allow a beautiful view of the
harbour. Additionally, a staff team room has been adapted to become a ‘quiet
room’ for residents who might have become agitated and need time to relax and
feel comfortable within their environment.” Mr Russell also pointed out that
patients did not spend all day in their pajamas, as one of the inspectors
claimed, and that there was now enough chairs in the unit’s dining room to
accommodate all patients. Inspectors had witnessed some patients sitting in
wheelchairs. “We believe this report was incredibly helpful and we are
grateful to the reviewers and Action on Alzheimer’s and Dementia charity who
brought the reviewers to Bermuda. There were some minor inaccuracies —
ankle restraints were not used — but we certainly believe it was a fair
reflection of what the reviewers saw during their visit. While the issues raised
concerned us, we have been pleased about the growing relationship with Action on
Alzheimer’s and Dementia. It is one thing to provide a review, but the charity
has stayed the course with us and become partners in improving the service and
environment for our residents. I would also recognize our staff, who have worked
on and implemented many of the actions. As the providers of the service, their
input, support and commitment to improve has been vitally important.”

2013. January 9. The final cost
of Bermuda’s new hospital will prove higher than many expect, the new Health
Minister has warned. But she promised to be keep the public informed as to where
the money is being spent. This week, Health Minister Patricia Gordon-Pamplin
vowed to press ahead with releasing BHB officers’ wages as part of the
Board’s accounts reporting. Responded BHB Chief Operating Officer Venetta
Symonds: “BHB remains committed to meeting the obligations mandated by the
Hospitals Act. We are currently also in the final weeks of our Corporate and
Clinical Governance Review, which will include recommendations regarding
transparency and accountability.” Ms Symonds said she would work closely with
the Board and the Minister to ensure that “an appropriate level of disclosure
is provided. Our financial statements for the fiscal year 2011/12 are currently
in the final stages of being audited. As soon as this process is complete, the
Annual Report will be compiled and produced. It will go through its usual
process through Cabinet and then the Houses of Parliament, at which point it
will be made widely available to the public. At a time when cost containment is
a top health concern, Ms Gordon-Pamplin also vowed to make good on One Bermuda
Alliance calls for the salaries of Bermuda Hospitals Board officers to be made
public. While in Opposition, the OBA chastised Government for its tardiness in
releasing BHB financial statements. Ms Gordon-Pamplin this week affirmed the
OBA’s bullish stance as Opposition on the release of wage figures.
“Absolutely,” said the Health and Seniors Minister, when asked if she would
follow through. “The BHB legislation requires disclosure.” Previous
administrations have published wages as a lump sum, which the OBA maintained
wasn’t sufficient. Ms Gordon-Pamplin conceded: “Obviously, there are some
things that may need to be relatively confidential. However, with that said, I
think that when we are spending public money, we have an obligation to let the
public know where that money is going. If you’re spending my money, I want to
know where it’s going. That’s just the way it is. We have made that
commitment to transparency.” Although the new hospital facility’s original
design and construction costs are given as $247 million, the project’s complex
financing as a Public-Private Partnership (PPP) carry significant long-term
costs. “From an accounting perspective, historically, PPPs end up costing
more,” Ms Gordon-Pamplin said. “That’s just the nature of it. The people
who have put their money up front want a return on their investment, which is
perhaps not an unreasonable expectation. The fact is that given the budgetary
constraints that we have operated under, given the economy as it is, there is no
way that we could have afforded to build the hospital. What’s interesting is
that within the debt number that we have heard, the hospital in not included —
because it’s deemed to be, within the accounting jargon, an off-balance-sheet
transaction with the PPP. So it’s going to perhaps end up costing us more, in
the long run.” The hospital remains on-budget, and scheduled to finish next
year, she said. “But the budget number that exists for the construction of the
building, you can be assured that is not the final amount that will have to be
paid at the back end for the cost of the construction. I still have to get a
handle on the exact amounts that we’re dealing with — but I expect it to be
high.” In the wake of an acrimonious election campaign which saw a war of
words over the FutureCare seniors’ insurance programme, the Minister
reiterated that the new administration has no intention of scrapping the
programme. “Election campaigns bring out the worst in people as they jockey
for position,” she said. “There was a big advertising campaign by the PLP
that we were going to take away FutureCare. That has never been the intention of
the OBA, and it’s certainly not the intention of the OBA Government.”
Government’s aim now is to “make it fair, so that people who are getting
specific benefits are paying the same amount. While one cannot fault people for
making the most of an opportunity that’s presented, I think there are people
who are harder done by who have a greater need than others. We want to look at
the entire concept. Sustainability is important.” Another legacy of the
previous administration is the legislation banning upfront payments for medical
treatment, which Ms Gordon-Pamplin said made eminent sense. “The one thing
that you will not get us doing is throwing out the baby with the bathwater. If
there is a policy that exists that makes sense, we obviously will allow it to
continue.” However, she said, the system would need tweaking: “I do believe
that we have to try to broker something where there is a little bit more
latitude on behalf of service providers, such that people do not feel as if they
have to do without healthcare simply because they do not have to $20 or $30 or
$40 for the co-pay. It’s something we have to work with. If we have to tie it
in with Financial Assistance, then we just have to make it robust. I don’t
want people being ill just because they don’t have a dollar.” Ms
Gordon-Pamplin could offer no advance details on healthcare expenditure in next
month’s Budget. “We have to recognize the fact that I can’t spend any more
money than is made available to me,” she said. “And we can’t have any more
available to me than exists from a budgetary perspective.” Promising a
healthcare system based on “sustainability and equity”, she added: “What
we want to make sure is that the people of Bermuda get the best bang for their
buck, if I can be so crude as to put it that way. It’s important to look at
everything, from the cost of pencils to the cost of imaging.”

2013. March 13. It was
announced that construction of the new hospital had so far injected $35 million
into Bermuda’s economy, with $125 million spent so far on construction orders.
More than 60 percent of the hospital construction workforce consists of
Bermudians, or spouses of Bermudians. The workforce averages 90 daily; at the
height of construction, that will rise to 250. With construction of the new
hospital on the doorstep of the existing hospital having been a challenge, the
impact of noise and dust was being kept to a minimum, with measures such as air
filtration inside the hospital, and washing of the wheels of vehicles before
they leave the site. Faults in the limestone at the site had required 4,300
cubic yards of backfill. Mock-ups of facilities such as a trauma area, ambulance
bays and patient bedrooms, have permitted modifications of designs. Equipment
purchases are expected to run up $40 million, with stringent reviews of requests
already in place. Construction at King Edward VII Memorial remains on
target for completion in 2014. At that point, the Bermuda Hospitals Board (BHB)
must pay project managers Paget Health Services $66.7 million. The BHB has been
increasing hospital fees by one percent annually, over five years under an
agreement formalized in Cabinet back in 2009, in preparation. The Bermuda
Government's 2012-2013 Budget has a spending cap of $104 million for KEMH but it
does not mean people will be denied services. It’s a paradigm shift. There
will no longer be a free-for-all. Hospital use for 2011/12 had exceeded
estimates. As well as the new cap on the KEMH subsidy, the BHB had piloted a
Memorandum of Understanding with a local insurer. With some of the risk
transferred onto the healthcare provider, it gave more inventive to the BHB to
ensure careful use of funds. BHB results of a three-year survey showed patient
satisfaction continually rising. Nurses have historically been in short supply.
Bermuda has 530 registered nurses, and BHB is aggressively courting Bermudian
medical professionals from overseas, as well as promoting further training at
home. Meanwhile, “fast tracking” incoming emergency room patients resulted
in 88 percent of patients getting a hospital bed with in six hours. A new food
delivery system had addressed a key problems with patient satisfaction, with a
new kitchen system in 2012. Once the hospital redevelopment has progressed
further there are plans to move the maternity ward next to the Operating Room.
This means that mothers in labour will no longer have to be wheeled through the
public corridors and taken in an elevator to the Operating Room. There is a
prospect of a new birthing centre, possibly with a birthing pool, after requests
by mothers in the community. For the Agape House hospice, BHB is adopting the
Liverpool Care Pathway, the latest model of best practice to comfort dying
patients and their families. The Island’s low rate of blood donation has
caused concern. Bermuda’s total blood donor population of 1,107 is less than
half that of comparable western countries. A total assessment of BHB’s
information technology has been completed, and electronic health records are to
be implemented at both hospitals. BHB will hire an expert to oversee the
procedure. The Queen Elizabeth Nursing Residence is increasingly unsafe
and demolition is the preferred option, but due to the recession, BHB believes
this can be put on hold. At the Mid Atlantic Wellness Institute (MAWI) the
Mental Health Plan is based on the recovery model. Assertive outreach teams are
now able to visit patients in their homes. Part of this can be seen in the
Budget with the allocation of $120,000 for vehicles to outreach teams. The team
also attends both Government senior schools to assess students, and a
residential team is in place to serve group homes. All 74 of MWI’s resident
learning disabled clients, who formerly lived on site at MWI, have transferred
to a group home in the past year.

2011. February. The BHB cut short its multi-million dollar five-year contract with
Kurron Shares by 18 months to save money. It cost Bermuda $13.5 million over
five years.

2011. February 26. The new
hospital will cost $13 million less than anticipated. According to the Bermuda
Hospitals Board [BHB], the final bill for the design and construction costs will
be $247 million. Any cost overruns will be the responsibility of Paget
Health Services, which is building the new facility. The original estimate of
$260 million was based on a Johns Hopkins Medicine International Report. In a
statement, a hospital board spokeswoman said: "BHB has chosen to deliver
the new facility through a public private partnership [PPP] that transfers many
of the project's risks, such as cost overruns and on time completion, to the
private partner. The PPP model also allows for cost certainty, and frees funds
to be used by BHB now to improve patient care and facilities, because the first
payment on the new building will not be made until 2014. A fair and competitive
bidding process between the three bid teams short listed by BHB helped keep the
project costs down." BHB chairman Herman Tucker, said: "It gives me
great satisfaction to see us come in under estimate. We have entered into a
project we know we can afford, and our private partner has financial incentives
to build, on time, a high quality hospital building. Paget Health Services will
also maintain the building for the length of the contract, giving Bermuda an
assurance that we will have a high quality, modern healthcare facility for the
next 30 years. As this is Bermuda's biggest construction project, any delays and
cost over-runs could be very damaging to us, especially as we face one of the
most challenging economic times in living memory. A key benefit of the way we
are delivering this new facility is that Paget Health Services take on the risks
of delays and cost over-runs. This is very good news for us and Bermuda as we
seek to control healthcare costs for the community." Deputy Chief Executive
Officer, Venetta Symonds, said: "We would like to thank the many people
involved in this project, from staff to government employees, community groups,
neighbours and advisors. It should give all of us great pride that we have
managed to come in under budget and that work has already started. We are really
looking forward to treating our first patients in the new building in
2014." BHB is responsible for paying Paget Healthcare Services $40 million
once the hospital has been built in accordance with the agreement. The rest of
the costs will then be paid over the course of 30 years, through annual
payments. According to the BHB statement: "The first year's total annual
payment obligation is $26.7 million. Like the capital costs of the construction
phase, this annual payment amount is less than BHB had budgeted for in its
capital financial planning process. All annual service payments will be
disclosed via BHB's regular financial reports."

2010.
Late. the Bermuda Hospitals Board (BHB) signed a project agreement for the
new hospital site, now being built (see photo at top of page).The agreement with Paget Health
Services (PHS), a consortium of experienced local and international firms,
allows them to design, build, finance and maintain the new King Edward VII
Memorial Hospital building at the existing site.The
new hospital is expected to begin
caring for patients in 2014. It is expected to cost over $260
million. It was announced in December 2011 that the first year cost alone to
taxpayers will be $66.7 million. There will be a 30-year payment schedule.

The
partnership between BHB and PHS includes a three-year construction phase and
30-year maintenance phase. The new building
will include 90 single-occupancy en suite patient rooms, Bermuda’s first
dedicated day surgery unit and ambulatory care services like oncology, dialysis,
asthma and diabetes management.It
will also include diagnostic imaging services and a new emergency room and
utility plant.

BHB
will make its first payment for the hospital redevelopment in 2014. Health
Minister Zane DeSilva told the House of Assembly under the agreement between
Paget Health Services (PHS), the company that will be building and maintaining
the property, and the Bermuda Hospitals Board (BHB), no money will exchange
hands until the construction is completed. PHS pays for construction of the new
hospital building, and the BHB pays nothing until it is complete in three years’
time to BHB’s specifications. BHB will retain ownership of the land and
building.

In 2007,
medical consultants Kurron Shares of America Inc won a five-year $13.5 million
contract to help BHB develop a long-term health care strategy for the Island,
beating a bid by world-renowned Johns Hopkins Medicine International. The
decision prompted criticism from doctors, who claimed Kurron Shares was “minor
league.” Also terminated was physician support contract with Greeley, which
was not renewed in 2011. A number of other smaller contracts have either been
terminated, not renewed or reduced. In total, net savings per annum are expected
to be in the order of $4 million.

The goal is to improve efficiency and find appropriate operational cost savings,
while continuing to improve health care services.

The continuous review is part of BHB’s commitment to consistently provide
value to the community in the face of rising health care costs and the current
economic challenges in Bermuda. It also reflects BHB’s responsibility to be
prepared to meet the financial obligations of the KEMH Redevelopment Project,
which includes making repayments for the new hospital facility from 2014 and
funding the revitalization of the existing KEMH facility. BHB’s succession
planning programme has identified Bermudians for senior leadership positions
that were once held by consultants. With plans for the new hospital facility
approved and a contract signed, the timing was right for a full review so that
we only maintain those contracts whose role remains vital for us to meet the long-term
health care needs of Bermuda. The Ministry of Health spent approximately $19.4
million on consultants between April 1, 2008 and January 31, 2010.

Bermuda-based Air Ambulance
services have been discontinued and will not be able to fly again unless
Government provides some money to help. The Bermuda Air Medivac plane has not
flown since November 2011. The service was dealt a double blow by a declining
number of patients and competition from cheaper US services. The air ambulance,
which was set up in 2004, made 500 trips to take sick people for specialist
medical help overseas before it folded. Patients ranged from head injury and
stroke victims to cardiac cases. Meanwhile, the plane which ran the service,
which was purchased with a charitable donation, remains in New York and may
eventually be sold. Earlier, in
the event of an emergency air evacuation from Bermuda to the USA or Canada, for
medical services that cannot be performed in Bermuda, Bermuda Air Medivac Ltd
was the operator of Bermuda's only emergency aircraft.A well-known philanthropist, David Barber, donated $2
million in 2005, in memory of his wife Mary, to buy an 11-seater jet for the
company.Before
the initiative, those critically injured or seriously ill had to wait for air
ambulances based in the United States and Canada to fly to Bermuda and transport
them off the Island.

Services
include:

Ambulances. All have automated external defibrillators
(AEDs). They are portable devices that under
medical supervision deliver a small electrical shock to restore normal heart
rhythm during sudden cardiac arrest, a condition that kills countless patients a
year. The average survival rate world-wide for sudden cardiac arrest is just 5
percent, but with fast treatment and an AED, there is a greatly improved chance
of survival. The operator of an AED turns on the device and places two pads on
the victim's chest. The machine assesses whether the heart is
"fibrillating" or quivering instead of beating normally. If an
abnormality is detected, the AED prompts the user to push a shock button to
deliver a shock to the heart. If it does not restore normal rhythm, the unit
repeats the process. An AED won't deliver an electrical charge to a person who
has simply fainted and does not have fibrillation. Many AEDs have now been
imported to Bermuda, thanks to a resident Australian philanthropist. In most
countries that have AEDs - but not yet in Bermuda - "Good Samaritan"
laws protect people who operate AEDs to treat a cardiac arrest victim.

Angiography.

Asthma

Bermudian medical
students. Those returning to the Island enjoy better opportunities for
work at KEMH than many of their overseas peers.

Blood Clinic. Created
in April 2012 by KEMH's cancer specialist/oncologist/haematologist Dr. Paul
Coty and colleagues, to help with blood diseases. Until then, patients had
to travel overseas for specialist attention. Local GPs sought out Dr Coty
because it is well known in the medical community that oncologists are
usually also blood specialists. Dr Coty said he thought it warranted a
separate clinic, because people with these blood diseases were not ill in
the same way that many cancer patients are. He said it would be better not
only for the patients with the blood disorders but also for the cancer
patients, to separate them. The clinic runs once a month on the second
Thursday of the month.

Cardiac
Diagnostic Unit. With a Cardiac
Rehabilitation Specialist and Personal
Cardiac Patient Folders of cardiac condition, family information,
prescriptions, etc. It opened officially in August 2002. Patients
undertake a stress test on a unit under the supervision of their doctor. The
unit is good but there is no cardio-pulmonary rehab
unit.

Cervical Cancer Screening.
Cervical cancer is believed to have a very good recovery rate when diagnosed
in time. In 2010,
there were 11 cases of severe pre-cancerous lesions (carcinomas that cannot
spread) in Bermuda and one case of invasive carcinoma (a carcinoma that can
or has already spread). KEMH is hoping to see these figures improve
greatly with the introduction of the ThinPrep Imaging System with Dual
Review, an advanced cervical screening system. Each Papanicolaou [Pap] test
is now analyzed by the new system and then screened by a skilled
cytotechnologist. Cells of interest are highlighted for the technologist to
review, helping them to better focus their skills on pre-cancerous cells.
This new method improves disease detection and enables early treatment
interventions to prevent cancer. The system is already in common use in the
United States and is thought to be the most accurate type of testing
currently available for cervical cancers. The Bermuda Hospitals Board (BHB)
is the only laboratory in Bermuda offering this process. They handle around
7,500 screenings a year, about half of all screenings done in Bermuda. Not
everyone’s Pap test comes to the hospital. They are either farmed overseas
or sent to KEMH. The new ThinPrep system combines advanced computer imaging
technology with human expertise to improve cervical cancer screening
efficiency and performance. It is the first fully integrated, interactive
computer system available to assist the experts in screening Pap test
slides. All cervical cancer tests at BHB are now screened using this system.
In general, doctors in Bermuda recommend beginning Pap testing when women
become sexually active. Women with certain risk factors may require frequent
testing and are encouraged to discuss cervical cancer screening with their
healthcare provider. These risk factors include a previous diagnosis of
cervical cancer or a Pap test that showed pre-cancerous cells, exposure to
diethylstilbestrol (DES) before birth, HIV infection and a weakened immune
system due to organ transplant, chemotherapy or chronic corticosteroid use.
Women can request their doctor or gynecologists send their Pap tests to the
hospital for testing in order to benefit from this new system. More than 30
published studies involving more than 500,000 patients have demonstrated
improved performance using the ThinPrep system. Improved accuracy of testing
means a better chance of early diagnosis and a better outcome for women with
cervical cancer. The old method was simply that KEMH would receive the cell
sample and a cytotechnologist would screen the pap test and diagnose it.
With the imager, advanced computerized technology will select cells of
interest that may be abnormal or atypical cells. It just highlights where
they are, but it still needs a human being to look at the test. The
combination of this computer technology with qualified cytotechnologists has
yielded a more sensitive Pap test to more effectively find abnormalities. It
looks for lesions, ideally to catch them at the pre-cancerous stage. The aim
is to get the pre-cancerous lesions and identify the patients who need
intervention before cancer develops. For pre-cancerous lesions there is no
need for radiation, they are just removed by surgery. Depending on how
severe, the patient is either closely followed up if they harbor a mild
pre-cancerous lesion, or removal by surgery will be performed for severe but
pre-cancerous lesions. It is only cancerous cases that need radiation
therapy. The pre-cancerous lesions are associated with the human
papillomavirus virus (HPV) infection. In Bermuda, like many parts of the
world, the HPV infection rate is very high. There is now an HPV vaccine
offered that protects against many of the major strains of the HPV virus.
The fact that KEMH seeing very low cervical cancer cases with high HPV
infection rates reflects the effectiveness of the local cervical screening
programme.

Child's wagons. To transport
children to the surgery room, to make the experience less traumatic. Donated by the Continental Society of Bermuda, a registered
charity.

Diabetes.

Diagnostic Scanner.
Brand new in February 2012, the
$1.48 million GE Discovery 128-slice CT machine provides faster scan times
and a reduction in radiation doses of up to 50 percent. The scanner is twice
as powerful as the 64-slice machine at Brown Darrell clinic, making it the
most powerful on the Island. The machine was donated to Bermuda Hospitals
Board by Hospitals Auxiliary of Bermuda. CT scanning is a form of diagnostic
imaging using X-rays at many different angles to get a picture of body
tissue. BHB’s new state-of-the-art technology gives physicians the ability
to see more anatomical detail in only a fraction of the time it took
previously. The new machine also offers virtual colonoscopy, a procedure
that displays images of the large intestine on a screen, permitting
physicians to assess and diagnosis digestive conditions using a less
invasive procedure than surgery. The lower radiation dosage reduces the
possibility of healthy tissue being damaged. The most important aspect of
the new machine is that it gives a clearer picture of what is happening in
the body. It enables doctors to diagnose problems faster and more
accurately. Blockages in blood vessels, for example, are clearly visible,
allowing doctors and patients to know the precise location of the problem.

Dialysis unit, new. Renamed and
upgraded as the Dr. Beresford Swan Dialysis Centre, named after the local
cardiologist who initiated it. But it is already in dire need of more space and, better facilities for the
patients who benefit from their services. Bermuda has one of the highest
rates in the world for dialysis users. There were 19 stations in the old
unit, now have 22 stations in the new unit and can do 16 more treatments per
day than in the old unit. The new unit operates for longer hours, from 4am
to 9pm, Monday to Saturday.

Digital UHF
Telemetry Machine, at three stations
in Cooper, Curtis and ICU wards. It enables patients to be monitored
appropriately.

Expressing room. A room
specifically for mothers to express milk, or breast-feed. Opened in February
2011. Nestled in the back
of the children’s unit on the second floor of King Edward VII Memorial
Hospital (KEMH), the small space features pictures of mothers and babies, a
desk, some shelves, a small fridge, a chair and some literature from the
breastfeeding support group, La Leche League. Being in the children’s
unit, sometimes the coos and cries of babies can be heard.

Heart Defibrillators. Nine
were recently donated to the hospital by Australian millionaire resident
Bruce Gordon, who also supplied many others island-wide.

High Intensity Focused
Ultrasound (HIFU). In Bermuda since 2010. A non-invasive alternative to
chemotherapy.One of the
ways in which Bermuda can actively explore
the expansion of medical tourism as a way to fill Bermuda’s empty hotel
beds. Cashing in on ‘medical tourists’ as well as their families and
doctors looks set to be one of the recommendations of the National Tourism
Plan. Medical tourism could be a major revenue generator. The medical
tourism industry is big business across the world and was introduced at King
Edward VII Memorial Hospital in 2010 with a new prostate cancer treatment
unavailable in the States. Government is now working behind-the-scenes to
“take things further” by actively promoting Bermuda as a medical
destination. It is hoped that Bermuda’s struggling tourism industry will
reap the benefits of large numbers of people coming for lengthy stays.
Bermuda’s proximity to the US and the offer of recovering in a beachside
setting are understood to make Bermuda an attractive destination for
patients. Bermuda Hospitals Board (BHB) has previously announced that High
Intensity Focused Ultrasound (HIFU) generated 1,000 bed nights for local
hotels in its first nine months. And since 2011 45 HIFU
patients have been welcomed to KEMH. Medical tourism could offer a boost to
the Island’s economy (but note that the USA's Medicare does not
cover overseas medical care.) Patients from North America would fly to Bermuda,
for treatment or recovery, in the same way they currently travel to Europe,
and UK visitors go to Europe or India, to avoid long waiting lists or high
costs. From a quality perspective, BHB will only consider offering
treatments and procedures to medical tourists that are evidence-based and
meet the standard of appropriate bodies. This means BHB will review
potential medical tourism opportunities extremely carefully. However, the
potential is there to benefit the hospital and Bermuda. It can also help
with recruitment as local healthcare professionals will have the opportunity
to work on some quality, leading treatments and procedures with
international specialists.

Medical tourism
with HIFU, above

Hyperbaric chamber.
Not all hospitals have one. Bermuda's is good. For decompression sickness.
It can strike both local and tourist divers. Our
bodies are designed to breathe freely on land. Once we go underwater there
is a change in atmospheric pressure. The pressure increases the further down
we go. Scuba divers take tanks of compressed air with them to breathe while
underwater. The air contains oxygen and nitrogen (it may also contain
helium). Oxygen breathed in is necessary for the body's cells to function
and gets used up, nitrogen however gets stored. The deeper we dive the more
nitrogen from the compressed air moves through the lungs and into the blood
and body tissues. The longer we stay in the deep, nitrogen dissolves and
accumulates first in those tissues with the most blood flow, eg the brain,
and more progressively the fatty tissues of our bodies. On longer dives some
or all of these tissues become saturated with nitrogen and will not accept
any more. As we swim back to the surface, there is a delay before saturated
tissues start to release nitrogen back to the blood. This is what causes
decompression problems. As indicated by its name, the problem is in
decompressing, moving from high pressure to low. When a critical amount of
nitrogen is dissolved in the tissues, a reduction of pressure, caused by
moving to the surface, induces the dissolved gases to be released and form
small clustered bubbles in tissue cells, tissue spaces and blood. Ascending
too quickly causes the dissolved nitrogen to return to gas form more quickly
increasing the number and size of the bubbles. This return-to-the-gas state
happens while the nitrogen is still in the blood or tissues. This causes the
characteristic decompression sickness pain and can also damage cells.

KEMH's Hyperbaric
unit

Image Analysis Machine, as a diagnostic
addition/extension of the Stress and ECG tests.

Lung cancer screening.
If
you’ve been a heavy smoker or have been subjected to second-hand smoke in
concentrations where you feel you might has well have been smoking yourself,
you might be concerned that you’ll develop lung cancer or worse, that
you’ve already got it. Now being offered not at KEMH but at the Brown
Darrell Clinic, with the CT scanner. The service is offered in partnership
with the Lahey Clinic of Massachusetts. Patients have to be referred by
their doctor for the scan. The local physician fills out a form which goes
to a radiologist specialist at the Lahey Clinic. Based on the information
from the local physician, the Lahey specialist gives specific instructions
on how to carry out the scan including where the patient should be
positioned. If follow-up is necessary, patients are not limited to having it
done at the Lahey Clinic. The files are kept electronically and can be
shared with any facility using the same system. Many Bermuda patients go to
Johns Hopkins. They will have a patient number which enables their results
to be shared with other facilities on the PAC (picture, archiving and
communication) system.

Mammography. Recently upgraded
to new digital equipment, offers digital mammograms. The
machine is equipped to provide stereotactic biopsies — the next diagnostic
step following a suspicious mammogram. In Bermuda in 2009, breast cancer was
the most commonly registered type of cancer in women and it was the third
highest cause of death from cancer. A woman's risk of breast cancer
increases with age. Having an annual mammogram after reaching 40 is one of
the best chances of catching breast cancer early. It should be part of an
annual wellness check, just like a pap test for cervical cancer.

Maternity Unit. The
maternity ward is now equipped with two modern operating rooms, a great step
forward in improving the safety and comfort of mothers, along with their
newborn children. One room will function solely as a state-of-the-art OR for
both planned and emergency Caesarean sections, with the second room retained
for routine deliveries but fully equipped as a backup OR. Both rooms are
next to the birthing rooms, making it easier for mothers in need of
emergency interventions. Previously, when mothers required emergency
C-sections, they had to be transported to a level above the delivery rooms.

Medical Clinic, now
closed. It once provided a safety net for seniors unable to pay HIP or
FutureCare, was closed several years ago by former Premier Dr Ewart Brown.
This clinic provided physicians, nursing care, medications and screening all
under one roof at this hospital, even transportation was provided.

Patients who incur very serious life-threatening problems who have insurance
or the means will continue to be sent to Johns Hopkins in
Baltimore, Maryland or Lahey or Spaulding in Boston, Massachusetts, by
air-ambulance, if needed.

Prostate Cancer Treatment
via High Intensity
Focused Ultrasound (HIFU), unavailable in the USA, yet to be endorsed by
the US Food and Drug Administration. Has brought medical tourists and their families and doctors to the Island since being made available
in 2010, said to have generated a total of 1,000 bed nights for
local hotels. Through a device called Sonablate (R) 500, HIFU works by
destroying prostatic tissue through extreme heat, produced from focused
ultrasound waves. It is described as a “minimally-invasive” prostate
cancer treatment. US HIFU is a private health care company based in
Charlotte, North Carolina. It says that compared to other therapies such as
surgery or radiation, HIFU has less significant side effects. Already, more
than 30 countries have medical facilities which use the technology.

Radiology. With a radiology information system from Arizona-based Misys Healthcare
Systems to make film unnecessary. All X-rays and cat scans now go directly
to a computer.

The scanner, which has four times as many
detectors as a typical single slice CT scanner, combines unequalled image
quality with remarkable speed.It can
produce detailed pictures of any organ in a few seconds and provides sharp,
clear, three-dimensional images, including views of blood vessels, in an
instant.Introduction
of the 64-slice CT scanner at the hospital will extend over the 2009/10
fiscal year, as it will require renovations in the CT area, along with the
addition of a digital image archiving system, needed to manage the vast
number of images produced by the new equipment.

Special
Care Baby Unit. For premature and other needy new babies.
Located
in the maternity ward, unlike in large hospitals abroad where it can be some
distance away from a maternity ward.

Ultrasound. A new portable unit was imported, especially for difficult
pregnancies.

Waste Treatment Plant.
Went online in 2014. It supplements and partly replaces the previous hospital
waste system piped across the South
Road to join into the City of Hamilton underground piped sewage system into Seabright Avenue, Paget and then,
at the southern end of Seabright Avenue, dumped untreated into the
sea.

X-ray
equipment, new in January 2013 was purchased thanks to the donations of
the Hospitals Auxiliary of Bermuda (HAB). The new equipment is intended to
replace a 16-year-old system at KEMH, which was becoming increasingly
difficult and expensive to maintain. It includes a replacement fluoroscope
which enables an imaging technique that uses X-rays to obtain real-time
moving images of the internal structures of a patient, called fluoroscopy.
Fluoroscopies are frequently used to investigate the gastrointestinal tract
or urinary tract, or provide an arthogram of joints. While the Hospital
Board paid $57,855 to install the system, the cost of the donated equipment
itself cost $419,864, all raised by the HAB through membership dues, The
Pink Cafe, The Gift Shop and The Barn. HAB donates around half a million
dollars to the Hospital Board annually to purchase new equipment, along with
supplying the hospital with numerous volunteers. This donation helped us
replace equipment that was increasingly challenging and costly to maintain.
The impact to patient care resulted in delays due to high levels of
maintenance, and extended downtimes. The HAB’s donation enabled KEMH to
improve quality with new technology and relieved the escalating financial
burden of keeping aged equipment running. The equipment will improve the
quality of care provided by the hospital, and will be moved to the new
hospital building when opened in 2014. The new equipment updates the
technology and enables KEMH to improve the quality of the images and reduce
the amount of contrast and radiation patients are exposed to in each test.

To
better regulate health professionals, there are now powers to suspend or bar
people for misconduct. The Professions Supplementary to Medicine Amendment Act 2006 , enacted by the
Bermuda legislature, ensures practitioners are competent and stay up to date
with the latest techniques and that there are more teeth for dealing with
complaints. The primary purpose is to ensure they meet established standards of
education, training and professional conduct and are educated about new
procedures that come along. Covering such professional categories such as
physiotherapist, occupational therapist and diagnostic imaging the Act
establishes a Council for Allied Health Professionals to promote patient
interests and exercise discipline over practitioners. A Preliminary Proceedings
Committee has been set up to investigate complaints – serious complaints will
then be referred to a Professional Conduct Committee which can hand out fines of
up to $2,000, suspend a person’s registration for a year or even bar them from
practicing.

Registers and/or interested
organizations include

Only persons on their respective registers are
recognized to practice in Bermuda. All involved who need or want further
details about registration should
contact the Administrative Assistant to the Council, Ministry of Health
and Family Services, P. O. Box HM 1195, Hamilton or telephone (441)
236-0224 extension 3441.

Age
Concern Bermuda

Bermuda-registered
charity # 137. 25 Point Finger Road, Paget DV 04, Bermuda. P.
O. Box HM 2397, Hamilton HM JX, Bermuda. Telephone (441) 238-7525. Fax
(441) 238-7177. Open to the public 9 am-4 pm
Monday-Friday. Not part of Age Concern in UK and not offering the
services they do. Most of the
income from this entity is from the corporate private sector, Bermuda
Government and some individuals. Income goes to operating expenses. It
will not campaign for free hospitalization and free prescriptions for
seniors. There is an annual membership fee to individuals.

Bermuda
Cancer and Health Centre

46 Point
Finger Road, Paget. P. O. Box HM 1652, Hamilton HM FX. Phone 236-0949.
RC 070. Formerly Bermuda Tuberculosis, Cancer & Health
Association. Since 1945, established by Act of Parliament. founded to
assist patients fighting TB. It educates the community about
prevention and early detection of cancer. It conducts 75% of all
mammograms. It educates and supports diabetic and ostomy patients. 25
percent of all deaths in Bermuda are attributed to cancer. Most common
types in Bermuda include (in descending order) prostate, breast, colon
and rectum, lung and bronchus, and skin. The Centrehighlights
the importance of early detection as the best form of prevention. Other
services include ultrasound and bone densitometry.

Bermuda
Council on Ageing

Since
late 2006. Charged with coercing Government to implement strategies
necessary to protect one the island’s fastest growing demographics.
The Department of Statistics estimates the over-65 population will
reach 22 percent by 2030 – double the amount of the 2000 Census. So
one of the most crucial roles for the Council is preparing the country
for an onslaught of elderly care giving – at home and in assisted
living facilities.

Founded
September 20, 2002. Chairman Mark Selley. Founded to help bring
much-needed long-term insurance and other pressing needs to Bermudians
and residents presently without the type of coverage or financial and
other support services common in other developed countries. Call
Chairman at "Ship's
Bow," 4 Keith Hall Road, Warwick WK 06, phone 236-0037

Bermuda Health
Council

A Bermuda
Government appointed entity. Established as an official health watchdog.
Responsible for regulating, coordinating and enhancing the delivery of
health services in Bermuda. Made up of doctors, insurers,
hospital officials and patients. Also responsible for regulating the
price of drugs sold to the public and conducting research on the
subject of public health.

For coronary
incidence, treatment and prevention. P. O. Box HM 1993, Hamilton, HM HX.
Telephone (441) 295 3346. Fax: (441) 295-5371. A registered charity,
1996. Unlike most support groups, it is a major player in arranging the
funding for critically important life saving heart related equipment for
the hospital and is supported by health professionals of the highest
reputation in every relevant field. It has no paid employees. Board
meetings are on the 3rd Thursday each month. Board of Directors include
Dr. Shane Marshall, MD, FRCPC. Goals are equipment, building, direct
services, education.

P. O. Box HM
2273, Hamilton HM JX. T. 441-298-0151. F. 441-296-1072. An independent organization founded as the formal charitable arm for
accepting donations and fundraising on behalf of the Bermuda Hospitals
Board (BHB). A separate entity from the
BHB and Ministry of Health, governed by its own Board of Trustees
who determine policy and are responsible for its own sound fiscal
management.

Bermuda
Integrated Health Service Cooperative (BIHC)

Lotus,
Victoria Street, Hamilton. Since 2012. BIHC, proponents of
out-of-hospital childbirth have won Immigration approval to bring their
own midwives to the Island. BIHC received permission after the Bermuda
Medical Council confirmed it didn’t need a full medical licence to do
so. The victory follows eight years of struggle, said director Sophie
Cannonier. “Midwives here in Bermuda function as obstetric nurses.
They are not available to the public for birthing outside the hospital.
So when I started to investigate through Immigration how I could bring
in midwives, that’s where the impasse came in. They said we were not
able to do it. I was told we couldn’t bring people in because I
wasn’t the holder of a medical licence. So we went back and forth
trying to get the door open.” Residents now have access to
Bermuda-registered US midwives Susan Cassel, Makeda Kamara and Lisa
Dalporto. The trio will work under the auspices of the BIHC, allowing
residents to give birth “anywhere they want.” The move could prove a
breakthrough in changing Bermuda’s medical culture, with costs far
lower than typical hospital births. BIHC is trying to negotiate
reasonable fees for insurance to cover BIHC services. Ms Cannonier
serves as Cooperative director alongside her husband Michael Watson and
Eugene Dean. With out-of-hospital midwifing “disappearing” across
the US its emergence in Bermuda is a special victory. BIHC hopes to
expand its services as more residents choose to explore their options.

Bermuda Medical
Association (BMA)

75 Victoria
Street, Hamilton. An association of all medical doctors in practice in
Bermuda.

Support, help, advice,
encouragement, to assist Bermudian and Bermuda-based stroke survivors of
all ages and backgrounds and families affected by stroke. Has no
membership dues, takes no minutes, has no structured agenda or board of
management. Strokes, more than any other medical problems, cause
permanent chronic disabilities. Stroke identification - how to identify
signs of a stroke - may be crucial. Getting a stroke recognized,
diagnosed, and then having the patient medically cared for within 3
hours, which is tough, can make the difference between life and death.
The stroke victim may suffer severe brain damage when people nearby fail
to recognize the symptoms of a stroke. Now doctors say a bystander can
recognize a stroke by asking simple questions, or looking carefully. Can
the person smile? Is the face crooked or normal? Can he/she talk and
speak a simple sentence coherently? ( For example, it is sunny out,
today). Speech is important. Can he/she raise both arms? Can he/she
stick out their tongue? If the tongue is crooked or goes to one
side or another, it's another cause for concern. If he/she has trouble
with any one of these four questions, call the doctor or hospital or
emergency service immediately and describe the symptoms.

Older adults often do not
realize or may even forget they have had a stroke and may not be a
reliable source of medical information, US researchers said in May
2009. Brain scans showed that while just 12 percent of seniors asked
about strokes remembered having had one, nearly a third had brain damage
showing they had. (Permanent brain damage results from a stroke). The
stroke itself could damage memory, and many people may also have
so-called silent strokes that are never diagnosed at the time. Stroke is
associated with motor impairment but can also be accompanied by
impairments in memory, sensation and speech or language, diminishing the
ability of an individual to accurately report a history of stroke.
Researchers who want to study strokes in adults young and old need to
rely on MRI scans, and not patients, to get accurate information about
stroke history.

50% of all strokes occur
in people who have no prior symptoms. Strokes are a leading cause of
severe permanent disability and death. People never recover fully from
strokes, their limbs or brain or heart are often permanently affected.
Some hospitals (unfortunately not in Bermuda) or private health systems
(such as LifeLineScreening.co.uk) offer ultrasound screenings that can
identify risk of strokes. Screenings are fast, painless, accurate and
often affordable, involving four tests. Test 1 is stroke carotid artery
screening. Test 2 is atrial fibrillation screening. Test 3 is abdominal
aortic aneurysm (AAA) screening. Test 4 is peripheral arterial disease
(PAD) screening.

Established
in 2006, it promote
patient interests and exercise discipline over practitioners. It has a
Preliminary Proceedings Committee, set up to investigate complaints –
with serious complaints referred to a Professional Conduct Committee
which can hand out fines of up to $2,000, suspend a person’s
registration for a year or even bar them from practising.

Diabetes
Resource Centre

Beacon
House, Beacon Street, Hamilton. People can get their blood sugar tested
and pick up supplies of insulin and syringes here, while patients
without adequate insurance coverage can get financial assistance from
Bermuda Diabetes Association.Visitors can also read publications related to
diabetes, while bi-monthly foot screenings are available by a
podiatrist.Support for the project has
come from Allied World Assurance, Butterworth Associates, XL, the
Bermuda Society for the Blind and the Corporation of Hamilton. The Long
Riders Motorcycle Club's 48-hour ride for diabetes last year raised
$18,000 towards costs.The
dispensary is open from 8.30 a.m. to 12.30 p.m. Monday to Friday.
Private consultations may be arranged in weekday afternoons. Telephone
297-8427 or 29-SUGAR for more information.

A register of names of doctors
under Section 6 (2) of the Medical Practitioners Act 1950 is maintained by the Bermuda
Medical Society and Bermuda Hospitals Board. It is in the order in which they were
registered in Bermuda.

Medical Reference Committee

A Bermuda Government committee
under the Motor Car Act 1951 to determine the fitness or otherwise of
licensed Bermuda drivers, especially those over 75 years old. See Bermuda
Government Boards.

Bermuda Government maintained under the
Professions Supplementary to Medicine Act 1973. A full list is published
annually.

Register of
Chiropodists

Bermuda Government maintained under the
Professions Supplementary to Medicine Act 1973, not in alphabetical
order but in order of day of registration so that those earliest currently
registered are first and the most recent are last. A full list every year.

Register of Dental Hygienists

Bermuda Government maintained under the
Dental Hygienists Regulations 1950. A full list every year.

Register of Dental
Technicians

Bermuda Government maintained under
Regulations 2(b) of the
Dental Technicians Regulations 1950. A full list every year.

Register of Dental
Practitioners

Bermuda Government maintained under
the Dental Practitioners Act 2008, not in alphabetical
order but in order of day of registration so that those earliest currently
registered are first and the most recent are last. A full list every year.
The new act amends the Dental
Practitioners1950 act which had no provision for registering dental
hygienists and assistants.The act also
requires dentists, hygienists and assistants to have continuing
education to remain registered, have a professional conduct committee
with mandatory reporting of impaired
practitioners, a report annually and
more. The Board increased from
five to seven members with the senior Government dental officer becoming
an ex officio member.The
Bermuda Dental Association and Bermuda Dental Hygiene Association will
be allowed to nominate members for the Minister to appoint, similar to
other medical boards.

Register of
Dieticians

Bermuda Government maintained under the
Professions Supplementary to Medicine Act 1973, not in alphabetical
order but in order of day of registration so that those earliest currently
registered are first and the most recent are last. A full list every year.

Register of
Emergency Medical Technicians

Bermuda Government maintained,
registered with the office of the Chief Medical Officer. Some are Bermuda
Hospitals Board, others are Bermuda Fire Service. A full list every year.

Register of
Medical Laboratory Technologists

Bermuda Government maintained under the
Professions Supplementary to Medicine Act 1973, not in alphabetical
order but in order of day of registration so that those earliest currently
registered are first and the most recent are last. A full list every year.

Register of Medical
Practitioners

Bermuda Government maintained under
Section 6 (2) of the
Medical Practitioners Act 1950, not in alphabetical order but in order of
day of registration so that those earliest currently registered are first
and the most recent are last. A full list every year.

Register of
Midwives

Bermuda Government maintained under
Section 6 (2) of the Midwives Act 1949, not in alphabetical order but in order of
day of registration so that those earliest currently registered are first
and the most recent are last. A full list every year.

Register of
Occupational Therapists

Bermuda Government maintained under the
Professions Supplementary to Medicine Act 1973, not in alphabetical
order but in order of day of registration so that those earliest currently
registered are first and the most recent are last. A full list every year.

Register of
Optometrists & Opticians

Bermuda Government maintained under
Section 4 Part III of the Optometrists and Opticians Act 1973, not in alphabetical order but in order of
day of registration so that those earliest currently registered are first
and the most recent are last. A full list every year.

Register of
Pharmacies

Bermuda Government maintained under
Part IV Section 17(4) of the Pharmacy & Poisons Act 1979, in alphabetical order. A full list
every year.

Register of
Pharmacists

In accordance with
Section 7 (4) of the Pharmacy & Poisons Act 1979. It shows every
currently licensed pharmacist - Bermudian and non-Bermudian - by full
first, middle and last name and the year, day and month when entered in
the register.

Register of
Physiotherapists

Bermuda Government maintained under the
Professions Supplementary to Medicine Act 1973, not in alphabetical
order but in order of day of registration so that those earliest currently
registered are first and the most recent are last. A full list every year.

Bermuda Government maintained under the
Professions Supplementary to Medicine Act 1973, not in alphabetical
order but in order of day of registration so that those earliest currently
registered are first and the most recent are last. A full list every year.

Register of
Speech-Language Therapists

Bermuda Government maintained under the
Professions Supplementary to Medicine Act 1973, not in alphabetical
order but in order of day of registration so that those earliest currently
registered are first and the most recent are last. A full list every year.

Standing Medical Board

Pension and
Gratuities (War Service) Act 1947. All surviving beneficiaries of such
pensions are senior citizens.

The
Psychological Practitioners Act 1998

For
psychologists practicing in Bermuda

Accommodation for doctors and
nurses from abroad

Some accommodation is available for incoming non-Bermudian doctors and nurses.
Incomers to Bermuda should know Bermuda is the wealthiest place in the world according to the
World Bank. Aspiring medical newcomers should check for themselves and make
appropriate comparisons to determine that terms and conditions of service
generally are comparable and equivalent in accommodation, length of service,
upward mobility, salaries, benefits and airfares to those offered in American,
Australian, Canadian, Cayman Islands, European and New Zealand hospitals. At all
such places abroad, for academically and professionally qualified staff standard attractions and
contracts include all local Board of Nursing or MD-certified or equivalent fees
paid, accommodation (one-bedroom or more) for a stipulated period of time, round-trip air
fares once every year or two, good local transportation options and financial
assistance if merited, good living
conditions and possibly a sign-on bonus.

Once, the hospital system was private
sector. At that time, it was supported by charity with the efforts of visitors like Mark Twain and British Army then in
Bermuda. Today, the costs to all who need the hospitals of Bermuda are not included in national direct and indirect taxes
as they are in Canada and the United Kingdom. There
is no national health plan in Bermuda.

Prudent visitors will bring spare money in US Dollars, travel insurance and health insurance to cope with possible
unexpected problems including accommodation in an emergency medical situation or a death. Visitors from the United Kingdom should note that the
National Health Service of the UK does not apply at all in Bermuda. Nor does it
have an equivalent. Medical costs here are as high as, often higher than, those
in the USA. Affordable
accommodation in Bermuda for such emergencies, especially from April to November, is
extremely difficult to find. Every week, visitors suffer
emergencies. Many say
they do not make any contingency or emergency
plans. They claim they have no money and no health and travel insurance for unexpected
problems. (When locals go the USA and elsewhere, on cruises or by
air, they must either have such a plan or be prepared to pay full medical costs
themselves).

In Bermuda, There is
no insurance coverage for birth control, only for abortions in certain approved
circumstances.

History of
hospitals in Bermuda

1812. 1st
Hospital. Royal Navy. Admiralty House, Long gone.

1818.
Construction of the once-grand Royal Navy Hospital near the Dockyard,
with the unusual cast and wrought iron building designed by
Edward Holl, Chief Architect for the Royal Navy and Scottish engineer,
John Rennie (1761—1821). It was built in
the same pre-fabricated manner as the later Commissioner's House,
initially as a Quarantine unit. British convicts transported to Bermuda
to build HM Dockyard, were treated here. When added to substantially
later, in addition to more cast iron structural features, such as
veranda columns, floor joists, and possibly cast and wrought iron roof
trusses, some of the stonework for the building was the hard local
limestone. A surgeon, doctors and medical staff were appointed
and sent by the Royal Navy. During World War 2, the Royal Naval
Hospital, Bermuda, treated and often saved the lives of many brought in
from torpedoed ships. The Royal Navy left in the 1950s. That
hospital building ended its life as an egg farm, then finally was
deliberately burnt to the ground by the Fire Department in November 1972
after it became a battery for producing chicken eggs. Later, it was the
site for Lefroy House, for senior citizens. Only rubble is left.

1841.
Planning of first Bermuda civilian hospital. . On 28 April,
the Bermuda Legislature passed an "Act for the Safe Custody of
Insane Persons charged with Offences. " It was the first local
legislation to deal specifically with persons with mental problems.
Persons charged, if found to be insane, were kept in custody until they
could be sent to an asylum. In 1846, a further Act was passed to
establish a hospital for the reception of "insane paupers." It
enabled the Governor, Lieutenant Colonel William Reid, to buy land in a
central parish for an asylum. Moved to and see under "St.
Brendan's Hospital" in Devonshire
Parish.

1848.
Opening of first Bermuda civilian hospital - the Lunatic Hospital
(as it was then called, insensitively). Dr. Henry
Josephus Hinson, a graduate of Edinburgh Medical School in Scotland, was
the first medical superintendent. It remained in its original location
for 22 years.

1864.
A Board of Health hospital was established at Cedar Hill, St. George's,
for victims of the Yellow Fever epidemic then raging in Bermuda.

1868.
Re-location and expansion of former Lunatic Hospital, now St. Brendan's.
It moved to its present location, the site of the former
Devonshire College. Later, under Governor General Sir John Lefroy, the
Devonshire College buildings were expanded after he convinced Parliament
to spend £3,650 sterling to pay for additional work. A much larger
facility was required from the beginning of the 20th century, especially
during and after the two world wars. St. Brendan's became its
official name, after the Irish saint born about 484 AD.

1850s. 3rd
Hospital. British Army, Prospect. Building still there,
British Army left in 1950s, continued as Bermuda Government-owned Old
Prospect Hospital until 1971/72. No longer a hospital.

1894.
March 11, Hospital Sunday. 4th
Hospital. Second civilian hospital. Patients of all classes who
required hospital treatment were admitted to the little rectangular
structure known as the Cottage Hospital which had only a handful of
beds. It was the first civilian (but not military, as there were two)
hospital in Bermuda. It was on elevated ground near the east end of
Pembroke Parish on the Military Road from Fort Hamilton to Prospect. It
subsequently became King Edward VII Memorial Hospital. See below.

1901.
Port's Island Hospital for Boer War prisoners-of-war. Also used
to house 3 German nationals interned and 58 German merchant seamen in
the 1914-18 Great War.

1920.
The first official Royal Visit to Bermuda was when Albert Edward, Prince
of Wales (later, briefly, King Edward VIII) concluded his tour of the
British Empire. It was the first of three visits to Bermuda by him. On
this first occasion, one of his official duties was the opening of
the King Edward VII Memorial Hospital on its present Paget
location, formerly the much smaller Cottage Hospital in Paget Parish.

1941.
First American hospital facility in Bermuda. American troops at the
Castle Harbour Hotel brought with them a medical contingent of eight
officers and men and established on a temporary basis on the first floor of the hotel an
infirmary, not a hospital.

1941.
August. First American Hospital in Bermuda. It was at what was was -
is now, again - the Bermuda Biological Station for Research at Ferry Reach.
The American Government obtained a lease of the buildings and
grounds (with the biologists re-housed at the Government Aquarium,
Flatts). A temporary American military hospital was established
there. It was staffed by four physicians, a dentist and nurses, all US
Army personnel. It was responsible for all members of the US Army
Engineers and the thousands of workers involved in the building of the
Fort Bell/Kindley Field Base.

1941.
September. US Navy began construction of an Annex Clinic at the first US
Armed Forces Base in Bermuda, in Southampton Parish. In 1993, it was
closed and amalgamated with the Base Clinic at USNAS, St. David's.

1941.
October. Work was begun by US Army Engineers on the building of an
elaborate 150-bed permanent hospital at Fort Bell. It is no longer
there but on the same site on which the present, much-newer, former US
military hospital - but now abandoned, vandalized and vacant - now
stands.

1942.
When the Riddell's Bay Golf Club was a US Navy recreation centre
during the war, a mobile hospital for the war-wounded was
established nearby. It too saved the lives of many brought in from
torpedoed ships. Others were brought in to the Royal Navy Hospital just
outside Dockyard (now Lefroy House).

1943.
May. The first US Military base hospital at Fort Bell was finally
completed, but only with the bare essentials, notwithstanding its
price-tag to US taxpayers of more than $1 million. But there were
sufficient facilities at the new site to justify giving plenty of
notice in advance of the closure of the infirmary at the Castle
Harbour Hotel and the temporary hospital located at the Bermuda
Biological Station.

1943.
December 30. With completion of the first purpose-built hospital
at Kindley Air Force
Base (KAFB), Bermuda, the infirmary that had been established at the
Castle Harbour Hotel was finally closed out and the hospital facility
that had been in operation at the Bermuda Biological Station was also
shut down.

1954.
It was resolved by the US
Military in Bermuda that the base hospital had to be demolished and re-built
from scratch at US taxpayers expense again as it had become too much of
a liability. Over time, it had been established its beams, concrete and
other structures were riddled with rust and related problems,
apparently with sea water instead of fresh water used for building, using
shoddy construction techniques.

1956.
June 21, 1956. Kindley Air Force
Base (KAFB), Bermuda celebrated
a major event, with Bermudian help. The occasion was the official
dedication of the brand-new base hospital up to latest US
hospital standards, on the site of the old building which had been
demolished because it had incurred some major building errors and its
foundations and walls were doomed. Its use was confined to civilian and
military employees and personnel of the US Military Forces in Bermuda
and their military colleagues at the British and Canadian bases in
Bermuda. It was designated
as the 1604th Hospital (and stayed that way until 1967 when it was
downgraded to a dispensary).Vanguard Construction of the USA
built the new building, at a cost to US taxpayers of more than
US$1,500,000. It had taken almost two years to build, mostly with
Bermudian labor, with the complete interior decoration work undertaken
by the Front Street, Hamilton firm of A. S. Cooper & Sons Ltd. The
grand opening, held under sunny skies outside the hospital's main
entrance, was attended by His Excellency, Governor Sir John Woodall; a
delegation from the USA including Dr. Frank B. Berry, then Assistant
Secretary of Defense (Health and Medical); Major General W. H. Powell,
Jr., Deputy Surgeon General, United States Air Force; and the Honorable
J. B. Pine, the United States Attorney General. Also in attendance were
the Hon. Sir John Cox, then the Speaker of the Bermuda House of
Assembly, the Venerable Archdeacon Stowe, who performed the Invocation
and the Right Reverend Robert S. Dehler, Roman Catholic Bishop of
Bermuda, who performed the Benediction.

1970.
Bermuda Hospitals Board (BHB) established. It brought King Edward VII
Memorial Hospital and slightly re-named St. Brendan's Psychiatric
Hospital under one governing body. Today, both are owned
and staffed by this specialist agency of the Bermuda
Government. See Bermuda
Government Boards. There is also a Bermuda
Hospitals Charitable Trust (BHCT), shown in Associations
in Bermuda, B Listing. More than 1,500 staff are employed by the two hospitals.

1971.
Patients were transferred from old Prospect Hospital to newly opened
Geriatric and Rehabilitation Unit at KEMH.

1995. When
US Forces quit
Bermuda, the former base hospital, by then demoted to a
dispensary and Base Clinic, was abandoned.